Upper Eyelid Advancement Flap 1
This is Richard Allen at the University of Iowa. This video demonstrates the use of an advancement flap to cover an upper eyelid defect. The incision is made medial and lateral to the flap in the eyelid crease, and triangles are designed to mimic a blepharoplasty incision. These triangles of skin are then excised as this would be excessive skin on the edges of the advancement. Westcott scissor are used, however, monopolar cautery could be used if desired. The dissection plane is between the orbicularis muscle and orbital septum. The flap is then widely undermined in the same dissection plane. Advancement of the flap demonstrates coverage of the defect. A small burrows triangle is excised medially, as is commonly performed in blepharoplasty incisions. The skin is then closed in this case with interrupted and running 7-0 nylon suture. At the conclusion of the case there should be minimal tension on the eyelid margin with no lagopohthalmos.