Semicircular flap revisited.

The semicircular flap of Tenzel has proved to be an excellent reconstructive procedure for central eyelid defects. Although originally described for defects measuring half of the eyelid, we have found that it may be used for defects greater than 60% in the lower eyelid, if the lower eyelid retractors and inferior orbital septum are identified and severed from their attachments. This is the key factor in the mobilization and advancement of this flap. It may, in many circumstances, obviate the need for a more complicated reconstructive procedure.