Upper Eyelid Reconstruction of Fricke and Kreibig

Large portions of the upper (and lower) eyelid can be reconstructed with a narrow transposition flap that is raised above the eyebrow on a lateral pedicle. Thick split retroauricular skin grafts can also be used.

Fig. 9.3 Mustarde's technique of upper eyelid reconstruction using a laterally based full-thickness flap from the lower lid (after Beyer-Machule and Riedel 1993).

a The full-thickness lower lid flap is outlined with a lateral pedicle. b The flap is swung into the upper lid defect, and the lower lid defect is closed. c Continuous suture line incorporates three interrupted sutures that close the defect and are taped to the skin. d, e About 3 weeks later, the pedicle is divided and the defects are closed.

Fricke FlapForehead Flap Eyelid Reconstruction
Fig. 9.4 Transposition flap from the forehead described by Fricke and Kreibig for reconstruction of the upper eyelid (a) and lower eyelid (b).
Continuous Mucosal Suture

Fig. 9.5a, b Closure of medial upper lid defects with a bilobed flap (see Figs. 5.3-5.7 and 5.24).

What Chondromucosal GraftFrecke Flap

Fig. 9.5a, b Closure of medial upper lid defects with a bilobed flap (see Figs. 5.3-5.7 and 5.24).

Fig. 9.6 Total upper lid reconstruction by Mustarde's two-step technique. a Laterally based semicircular lower lid flap is used to reconstruct the upper lid (see Fig. 9.2). A chondromucosal composite graft is taken from the septum. The mucosal part of the graft is twice as large as the cartilaginous part.

b The composite graft is used to replace the lower lid. c All defects are closed. Three weeks later the pedicle is divided and inset (see Fig. 9.3d, e) (after Beyer-Ma-chule and Riedel 1993).

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