Modified Tripier flap in reconstruction of the lower eyelid

Abstract

We describe the use of modified Tripier flap for reconstruction of a surgical defect in the lower eyelid region, after excision of nodular basal cell carcinoma.

Periocular Malignancies and Postoperative Eyelid Reconstruction

“…With the increase in applications, there have been many changes to the initial approach, such as the use of a single pedicle that can be medially or laterally positioned, depending on where the lower eyelid defect is, with or without the inclusion of the orbicularis, and without the requirement of a second phase procedure to section the pedicle. 87,88 The modified Tripier flap must not be confused with the Fricke flap. The latter is distinguished as a solely cutaneous flap for transposition, monopediculated, from the supraorbital region of the frontal region to the palpebral region.…”

“…In contrast, faults affecting the entire lower eyelid can be reconstructed with a bipedicled flap. 88,90 Fricke (Temporal Forehead) Flap Jochim Fricke described the temporal forehead flap for the first time in 1829. 91 It is a laterally based, unipedicled transposition flap raised above the eyebrow, which can be used to reconstruct large lower and upper eyelid and lateral canthal defects.…”

“…(Figure 4) The benefit is that it contains muscle fibers, which gives it some heft and enhanced vascularity. With the increase in applications, there have been many changes to the initial approach, such as the use of a single pedicle that can be medially or laterally positioned, depending on where the lower eyelid defect is, with or without the inclusion of the orbicularis, and without the requirement of a second phase procedure to section the pedicle 87,88 . The modified Tripier flap must not be confused with the Fricke flap.…”

Surgical Strategies for Eyelid Defect Reconstruction: A Review on Principles and Techniques

“…A unipedicled flap can be used to repair defects involving 1/3–1/2 of the lower eyelid (Fig. 4 ), and a bipedicled flap can be used for total lower eyelid defects [ 27 , 28 ]. This flap has been modified to an island Tripier flap for aesthetic reconstruction of subtotal defects away from the lateral canthus and a reverse Tripier flap for upper eyelid reconstruction [ 29 ].…”

Review of Eyelid Reconstruction Techniques after Mohs Surgery

“…53 Since the original publication, many modifications have been made, including using a single pedicle either laterally or medially located, depending on the location of the lower eyelid defect with or without the inclusion of the orbicularis that does not involve the need for a second-stage procedure to section the pedicle. [54][55][56] The Hughes flap is a two-stage, eyelid-sharing technique that involves the use of an upper eyelid tarsoconjunctival flap advancement and skin graft for the reconstruction of fullthickness lower eyelid defects (►Fig. 4).…”