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Aesthetic Correction of Severe Cicatricial Upper-Eyelid Ectropion with a Retrograde Postauricular Island Flap

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Abstract

Background

Cicatricial ectropion of the upper eyelid is a serious problem because of the association with exposure keratitis and ulceration. Traditional surgical treatment usually requires skin grafts or local flaps depending on the severity of the defect. However, outcomes have usually been discouraging, especially in terms of cosmetic appearance.

Methods

From February 2000 to March 2012, a total of 12 upper eyelids with severe cicatricial ectropion were treated with a retrograde postauricular island flap and were included in this study. Based on the pedicle of the parietal branch of the superficial temporal artery and its choke anastomoses to the posterior auricular artery, the retrograde postauricular island flap was harvested with a supra-auricular incision down to the non-hair-bearing side skin of the postauricular region. The flap was then transferred to the upper-lid lesion by passing it through a subcutaneous tunnel between the pedicle base and the upper-lid lesion. The donor site was directly closed by advancing the postauricular scalp flap into the sulcus. The largest flap was 6.5 × 3.5 cm2.

Results

After 6–12 months of follow-up, flaps survived with good color, texture, and contour. The eyelids moved freely without recurrence of ectropion. The donor site had an inconspicuous scar. No major complications occurred.

Conclusions

The retrograde postauricular island flap can be a safe, simple, and effective procedure for aesthetic correction of severe cicatricial upper-eyelid ectropion with few complications and little donor-site morbidity.

Level of Evidence V

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Conflict of interest

The authors have no conflicts of interest to disclose. None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this article

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Correspondence to Jincai Fan.

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Fu, S., Fan, J., Chen, W. et al. Aesthetic Correction of Severe Cicatricial Upper-Eyelid Ectropion with a Retrograde Postauricular Island Flap. Aesth Plast Surg 37, 95–101 (2013). https://doi.org/10.1007/s00266-012-0009-9

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  • DOI: https://doi.org/10.1007/s00266-012-0009-9

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