Animation demonstrates how an upper eyelid defect can be reconstructed after a malignant upper eyelid lesion has been excised. The Cutler-Beard bridge flap procedure demonstrated here can be used to reconstruct upper eyelid defects up to 90% in size. The bridge flap is a two stage lid sharing procedure. In the first stage, a full thickness pedicle is transposed from the lower eyelid to the upper eyelid. The second stage entails dividing the pedicle bridge.

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Great example of an Aframe deformity after mohs resection.
Although the origin of the Aframe is from a skin cancer resection the same concepts could be used in the case of an over-resection during a cosmetic upper blepharoplasty.
A number of items needed to be addressed to make the right lid deficit no stand out so much when compared with the left upper lid.
There is a loss of prelevator fat combined with a constricted skin shortage on the right upper lid following the cancer resection by the Moh's surgery.
This right medial lid shortage combined with the lateral and contralateral dematochalasis accentuates the A Frame deformity and really draws your gaze toward the defect.
I repaired the defect with a combination of upper blepharoplasty, skin desection off the muscle and fat grafting to the defect itself. Additionally a simple left blepharoplasty helps to make the lids more symmetric overall.

SightMD Oculoplastic Surgeon Dr. Baharestani talks us through Eyelid Cancer, and all you need to know to raise awareness. Learn More - https://www.sightmd.com/blog/d....o-i-have-eyelid-canc

Skin Cancers on the Face & Body seem to be steadily increasing in frequency. This is not only in the Caucasian races (where melanin does not protect the skin from the ultra-violet sun rays), but there is a steady increase in skin malignancy even in pigmented races like Asian Indians and the Hispanic population.

Every skin mole, every skin lesion, every skin mass, should be viewed with suspicion and considered as cancer, unless proven otherwise. Therefore, every skin lesion, even if it appears benign and like a harmless skin cyst, should have an excisional biopsy performed and be subjected to pathological examination, to diagnose the same better.

The eyelid skin is susceptible to multiple skin tumors like the basal cell carcinoma (also knows as the rodent ulcer), the squamous cell cancer (starting from the actinic keratosis), the sebaceous gland carcinoma and the Merkel Cell Cancer. In addition, malignant melanomas can also appear in the eyelid skin. But, later, they continue to increase in size and may even cause a skin ulcer (like basal cell cancer rodent ulcer) or cause bleeding. The basal cell cancer is locally destructive and usually does not cause any threat to life, but the sebaceous cell carcinoma can metastatize to distant organs like the liver and the lung and even cause death.

Skin prevention by using sun screen & avoiding tanning salons can protect against skin cancer. Removal of skin cancer can be performed by Mohs micrographic surgery or by frozen section diagnosis with cancer free margin clearance. Mohs surgery is considered the best skin cancer treatment in the world. Reconstruction of the skin defect post the skin cancer removal, is treated with skin grafting or a combination of plastic surgery reconstruction flaps like the Tenzel's semicircular flap, the mustarde's cheek rotation flap, the Cutler Beard flap, Hughes flap and others.

In this video, Ms. Nagamma, from Guntur, India, developed a small mole like eyelid mass, below her right lower eyelid. Initially, she chose to observe it, but as the mass kept on increasing, she presented to top facial plastic surgeon, Dr. Debraj Shome. Dr. Debraj Shome performed an excisional biopsy and removed the eyelid mass and then performed a reconstruction eyelid surgery with a flap surgery (oculoplastic surgery), to recreate the entire lower eyelid. The patient had completely symmetrical eyelids, post the oculoplastic eyelid surgery, and she has been cancer free for the past ten years.

For consultations with top oculoplastic surgeon Dr. Debraj Shome, please write in to info@theestheticclinic.com or call +91-9619610388.

Dr. Shome's website is http://www.theestheticclinic.com, http://www.facialplasticsurgeonindia.com, http://oculoplastic-eyelid-orbit-surgery.com
His Official Blogs are http://www.debrajshome.com
Other Resource Links about Dr. Shome-
http://en.wikipedia.org/wiki/Debraj_Shome
https://in.linkedin.com/in/drdebrajshome
http://www.theestheticclinic.c....om/about/doctors/deb
http://www.facialplasticsurgeo....nindia.com/dr-debraj

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In this video, see Dr. Taban work with a 53 year old female, who underwent left lower eyelid skin cancer reconstruction after Mohs surgery to remove basal cell carcinoma.
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Every eyelid mass can be an eyelid cancer & needs to be viewed with suspicion. The commonest eyelid cancers are basal cell carcinoma, squamous cell carcinoma, sebaceous gland carcinoma, Merkel cell carcinoma, malignant melanoma, etc. Initially, these eyelid masses can appear like benign eyelid swellings like chalazion & eyelid stye; but later these eyelid tumors can become aggressive and cause local tissue destruction & also metastasize to distant organs like the liver and the lung, thereby causing a threat to life.

In the Western population, basal cell cancer & squamous cell cancer are the most common eyelid cancers. But, in the Indian population, sebaceous cell carcinoma is also relatively more common. Sebaceous gland carcinomas are extremely aggressive eyelid skin cancers and cause a threat to life. Tumor needs to be removed by Mohs micrographic surgery, this is the best way to confirm cancer margin clearance. Frozen section biopsy can also be performed and histopathological examination of the removed eyelid mass performed. Post the tumour removal, additional chemotherapy or radiotherapy treatment may be required.

Since sebaceous carcinomas arise from the sebaceous glands in the upper eyelid, they can involve the entire eyelid. Resultantly, the eyelid defect created from the tumor removal needs to be reconstructed using flap surgery. Reconstructive plastic surgery Flaps used to reconstruct eyelid defects include the Tenzel Flap, the Cutler Beard flap surgery, the Hughes tarso-conjunctival flap, the Mustarde's cheek rotation flap & other types of reconstruction flaps. The Cutler Beard flap surgery takes a lower eyelid bridge flap to correct the upper eyelid defect, in stage I surgery. Post the healing, in stage II surgery, the bridge flap is divided and the upper eyelid completely reconstructed.

Oculoplastic surgeons perform eyelid plastic & reconstructive surgery to repair the eyelid, post eye cancer removal. Oculoplastic surgeons are specially trained in reconstructive eyelid surgery & ocular oncology, so they are the best at treating eye cancers, eyelid tumors & reconstruct the eyelid and the face, post cancer removal. In this video, a patient from India, with a sebaceous gland cancer of the left upper eyelid, is treated with a Cutler Beard reconstruction flap (oculoplastic surgery), by top oculoplastic surgeon Dr. Debraj Shome. The patient did well post eyelid surgery and she has been cancer free over a ten year follow-up. Dr. Debraj Shome is amongst the best oculoplastic surgeons in the world and currently practices at multiple top hospitals in Mumbai, India.

For oculoplastic surgery consultations with top oculoplastic surgeon Dr. Debraj Shome, please write in to info@theestheticclinic.com or call +91-9619610388.

Dr. Shome's website is http://www.theestheticclinic.com, http://www.facialplasticsurgeonindia.com, http://oculoplastic-eyelid-orbit-surgery.com


His Official Blogs are http://www.debrajshome.com and http://debrajshome.wordpress.com


Other Resource Links about Dr. Shome-

http://en.wikipedia.org/wiki/Debraj_Shome

https://in.linkedin.com/in/drdebrajshome

http://www.theestheticclinic.c....om/about/doctors/deb

http://www.facialplasticsurgeo....nindia.com/dr-debraj

http://oculoplastic-eyelid-orbit-surgery.com/surgeon/debraj-shome/

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