Orbicularis Muscle Mobilization in Eyelid Reconstruction

Reconstruction of Upper Eyelid Defects Secondary to Malignant Tumors with a Newly Modified Cutler-Beard Technique with Tarsoconjunctival Graft

“…We believe an earlier separation would not compromise vascularity, but could produce eyelid retraction, as it has been observed in other cases of early separation in Hughes flap reconstructions [22].…”

Reconstruction of Upper Eyelid Defects Secondary to Malignant Tumors with a Newly Modified Cutler-Beard Technique with Tarsoconjunctival Graft

“…We believe an earlier separation would not compromise vascularity, but could produce eyelid retraction, as it has been observed in other cases of early separation in Hughes flap reconstructions [22].…”

The Tarsoconjunctival Flap for Lower Lid Reconstruction-Review of Literature and Case Series

“…Doxanas [22] modified the Hughes procedure by adding orbicularis oculi muscle mobilization. He noted that placing a full-thickness skin graft over the Tarsoconjunctival flap on the lower lid forced blood destined for the graft to diffuse from the conjunctiva through the essentially avascular tarsal plate to reach the graft.…”

Reverse Modified Hughes Procedure for UpperEyelid Reconstruction

“…16 This is possibly because of the inevitable scarring resulting from placement of the skin graft onto the avascular tarsus. 16 However, the advancement of the wellvascularized orbicularis muscle between the skin and the tarsoconjunctival flap reduces scarring to produce a thicker and softer eyelid.…”

“…The orbicularis muscle, with its robust blood supply, enhances the viability of the reconstructed eyelid and could also reduce the period between the primary operation and the secondary revision of the flap. 16 The Hughes flap was traditionally left for 6 weeks, but several published studies revealed that vascularization of the reconstructed eyelid appears to occur more rapidly than was originally thought. Leibovitch and Selva 22 reported good results in 29 patients with early division of the Hughes flap at 1 week.…”

“…However, loss of the downward pull provided by the tarsoconjunctival flap during the healing period may result in the retraction of the reconstructed eyelid. 16 Therefore, we suggest that waiting enough time to stretch the flap properly may be necessary when there are extensive and deep defects, or the donor eyelid is tight, especially in young patients.…”

Reconstruction of Upper Eyelid Defects Secondary to Malignant Tumors with a Newly Modified Cutler-Beard Technique with Tarsoconjunctival Graft

“…We believe an earlier separation would not compromise vascularity, but could produce eyelid retraction, as it has been observed in other cases of early separation in Hughes flap reconstructions [22].…”

The Tarsoconjunctival Flap for Lower Lid Reconstruction-Review of Literature and Case Series

“…Doxanas [22] modified the Hughes procedure by adding orbicularis oculi muscle mobilization. He noted that placing a full-thickness skin graft over the Tarsoconjunctival flap on the lower lid forced blood destined for the graft to diffuse from the conjunctiva through the essentially avascular tarsal plate to reach the graft.…”

Reverse Modified Hughes Procedure for UpperEyelid Reconstruction

“…16 This is possibly because of the inevitable scarring resulting from placement of the skin graft onto the avascular tarsus. 16 However, the advancement of the wellvascularized orbicularis muscle between the skin and the tarsoconjunctival flap reduces scarring to produce a thicker and softer eyelid.…”

“…The orbicularis muscle, with its robust blood supply, enhances the viability of the reconstructed eyelid and could also reduce the period between the primary operation and the secondary revision of the flap. 16 The Hughes flap was traditionally left for 6 weeks, but several published studies revealed that vascularization of the reconstructed eyelid appears to occur more rapidly than was originally thought. Leibovitch and Selva 22 reported good results in 29 patients with early division of the Hughes flap at 1 week.…”

“…However, loss of the downward pull provided by the tarsoconjunctival flap during the healing period may result in the retraction of the reconstructed eyelid. 16 Therefore, we suggest that waiting enough time to stretch the flap properly may be necessary when there are extensive and deep defects, or the donor eyelid is tight, especially in young patients.…”

Reconstruction of Upper Eyelid Defects Secondary to Malignant Tumors with a Newly Modified Cutler-Beard Technique with Tarsoconjunctival Graft

“…We believe an earlier separation would not compromise vascularity, but could produce eyelid retraction, as it has been observed in other cases of early separation in Hughes flap reconstructions [22].…”

The Tarsoconjunctival Flap for Lower Lid Reconstruction-Review of Literature and Case Series

“…Doxanas [22] modified the Hughes procedure by adding orbicularis oculi muscle mobilization. He noted that placing a full-thickness skin graft over the Tarsoconjunctival flap on the lower lid forced blood destined for the graft to diffuse from the conjunctiva through the essentially avascular tarsal plate to reach the graft.…”

Reverse Modified Hughes Procedure for UpperEyelid Reconstruction

“…16 This is possibly because of the inevitable scarring resulting from placement of the skin graft onto the avascular tarsus. 16 However, the advancement of the wellvascularized orbicularis muscle between the skin and the tarsoconjunctival flap reduces scarring to produce a thicker and softer eyelid.…”

“…The orbicularis muscle, with its robust blood supply, enhances the viability of the reconstructed eyelid and could also reduce the period between the primary operation and the secondary revision of the flap. 16 The Hughes flap was traditionally left for 6 weeks, but several published studies revealed that vascularization of the reconstructed eyelid appears to occur more rapidly than was originally thought. Leibovitch and Selva 22 reported good results in 29 patients with early division of the Hughes flap at 1 week.…”

“…However, loss of the downward pull provided by the tarsoconjunctival flap during the healing period may result in the retraction of the reconstructed eyelid. 16 Therefore, we suggest that waiting enough time to stretch the flap properly may be necessary when there are extensive and deep defects, or the donor eyelid is tight, especially in young patients.…”