Scalping forehead transposition flap for total eyelid reconstruction with periocular involvement associated with a conjunctival cyst formation.

INTRODUCTION: Total upper and lower eyelid loss due to carcinoma or trauma while conserving a functioning eye is rarely seen. In such cases being able to maintain the ocular surface may prove to be a surgical challenge, more so when there is a history of tumor recurrence, multiple procedures or tissue loss that exceeds the palpebral region, thus limiting the reconstructive options.

CASE AND TECHNIQUE: We present a case report where a scalping forehead transposition flap pedicled on the superficial temporal artery territory was performed to reconstruct a full thickness skin defect that involved the dorsum of the nose, cheek, upper and lower eyelids. A conjunctival advancement flap for ocular surface protection was used that unexpectedly rendered a cystic cavity that functioned as a tissue expander.

COMMENT: Although the technique requires at least two surgical stages, we recommend this approach when other options are not feasible.