Eyelid Reconstruction
Eyelids are essential to protecting your vision — they distribute the tear film, block debris, and prevent corneal exposure. When tissue is lost to cancer, trauma, or burns, expert reconstructive surgery restores both function and appearance.
Restoring Function First — Appearance Second
The eyelids are the most complex functional skin structure on the body. Reconstruction must restore the lid's ability to blink fully, close at night, and protect the cornea from exposure — while achieving an aesthetically natural result.
Dr. Shepler uses a variety of tissue techniques — skin flaps, mucosal grafts, tarsal grafts, and composite grafts — selected based on the defect size, location, and patient anatomy.
Common Indications
Reconstruction Approaches
Direct Closure
Small defects (up to 25% of the lid) can often be closed directly after removing skin-edge tension with canthal release maneuvers. Produces minimal scarring when tension is well-managed.
Skin & Muscle Flaps
Adjacent tissue is rotated or advanced to cover larger defects. Common flaps include the Tenzel semicircular flap for lateral defects and the Tripier flap for lower lid reconstruction.
Hughes Tarsoconjunctival Flap
A two-stage technique for large lower lid defects — the posterior lamella is borrowed from the upper lid and covered with a skin graft, then divided at 4–6 weeks when vascularized.
Full-Thickness Grafts
Skin harvested from the upper eyelid, preauricular, or retroauricular area replaces anterior lamellar defects. Color and texture match is critical for an optimal cosmetic outcome.
Mucosal Grafts
Buccal mucosa or hard palate grafts replace the posterior lamella when these layers are extensively damaged by disease, burns, or prior surgery.
Free Tarsal Grafts
Tarsus harvested from the upper lid provides rigid structural support for lower lid reconstruction — essential for maintaining proper eyelid position and preventing post-op ectropion.
Schedule Your Reconstruction Consultation
Whether following cancer removal or after trauma, Dr. Shepler will design a reconstruction plan that protects your vision and restores natural eyelid appearance.