Upper lid musculocutaneous flap.

The use of a musculocutaneous flap from the upper lid for reconstruction in the orbital region and neighboring areas is described. The anatomical basis is considered. Because of its blood supply, the flap can be raised on its lateral or medical pedicle. When based on its lateral pedicle, innervation can be maintained by raising an innervated musculocutaneous flap, which can restore proper lower lid position and tonus. Twenty-two patients were operated on with this technique to fill defects of the lower and upper lid as well as of the lateral nasal wall. All flaps survived, and only minor deformities of the donor site were seen when the eyebrows were included in the flap.