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CC BY 4.0 · Arch Plast Surg 2025; 52(04): 234-238
DOI: 10.1055/a-2621-7781
Pediatric/Craniomaxillofacial/Head and Neck
Case Report

Reconstruction of the Posterior Lamella of the Lower Eyelid Using a Long L-Shaped Periosteal Flap: Technical Modification and Literature Review

Hikaru Kono 
1   Department of Plastic and Reconstructive and Aesthetic Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
,
Fumio Onishi 
1   Department of Plastic and Reconstructive and Aesthetic Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
,
Yu Kagaya 
1   Department of Plastic and Reconstructive and Aesthetic Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
,
Hiroto Obata 
2   Department of Ophthalmology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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Funding None.
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Abstract

Free tarsal grafts, the palatal mucosa, and auricular cartilage are commonly used in the reconstruction of the posterior lamella of the eyelid. However, reports describing the sole use of periosteal flaps are limited. We described the cases of two female patients, aged 72 and 85 years, with sebaceous gland and basal cell carcinomas of the left lower eyelids, respectively, who underwent reconstruction with a long L-shaped periosteal flap. The periosteal flap, measuring approximately 6 × 25 mm, was harvested along the vertical axis over the lateral orbital rim, extending across the frontozygomatic suture with the pivot positioned posteriorly at Whitnall's tubercle. This technique enabled the reconstruction of the posterior lamella of the lower eyelid. At the 1-year follow-up, mild sagging of the reconstructed area was observed in the second case; however, no major complications occurred. Thus, the long L-shaped periosteal flap was useful for reconstructing the lateral lower eyelid.

Keywords

lower eyelid defect - eyelid tumors - periosteal flap - myocutaneous advancement flap - frontozygomatic suture

Note

This study was presented at the 27th Annual Meeting of the Japan Society of Plastic and Reconstructive Surgery, April 2024, Tokyo, Japan.


Authors' Contributions

Conceptualization: H.K.

Methodology: all authors.

Writing – original draft: H.K.

Writing – review and editing: all authors.


Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


Patient Consent

Patients provided written consent for the use of their images.




Publikationsverlauf

Eingereicht: 26. September 2024

Angenommen: 08. Mai 2025

Accepted Manuscript online:
27. Mai 2025

Artikel online veröffentlicht:
23. Juli 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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