Simultaneous upper and lower eyelid reconstruction using a first web space free flap.

The authors present a case of near-total upper and lower eyelid defects treated with a first web space free flap after a chemical burn injury. A first web space free flap was raised from the ipsilateral foot and transferred to the defect with its base turned toward the medial canthal area. The first dorsal metatarsal artery and veins were anastomosed to the superficial temporal artery and veins, respectively. The inner layer of the flap was sutured to the advanced upper and lower palpebral conjunctival flap from conjunctival cul-de-sacs, and the outer layer of the flap was sutured to the defected skin. Flap-debulking procedures were carried out 3 times after the microsurgical procedure. Postoperative aesthetic results were good, except for minor problems that included focal symblepharon and sebum formation. The described method could be used as an alternative for total eyelid reconstruction, especially in patients without available local facial tissue because of burns or trauma.