Mustardé flap lower lid reconstruction after malignancy.

The Mustardé rotational cheek flap has been used to reconstruct the lower eyelids of 55 patients since 1964. Results and complications were well-documented with preoperative and postoperative photographs, and the patients have been followed from one to 14 years with a mean age follow-up of seven years. The most frequent complications were downward contraction and sagging of the flap and ectropion of the lid margin. To prevent them, the zygomatico-cheek flap must be carefully designed, rotated, and sutured as high as possible so that immediately postoperatively, the palpebral fissure is only a narrow slit. The flap's lining should be of nasal septal mucosa and cartilage joined with permanent sutures to the medial and lateral canthal tendons.