Published: 2021-01-29

Skin graft of contralateral aesthetic unit for reconstruction of the upper eyelid: case report and literature review

Heriberto Garza de la Llave, Jose de Jesus Orozco-Grados, Carlos Eduardo Rodriguez, Enrique Chavez-Serna


Eyelids represent a complex structure; its principal function is to provide physical and immunological barrier. The complexity of this structure lies in the blinking and in the range of movement they carry out respecting the integrity of the cornea. The objective of this study is to provide a surgical alternative with minimal morbidity for the reconstruction of the upper eyelid, as well as to present the available tools for the treatment of this complex area of the facial anatomy. We present the case of a female patient of 62 years, with 50% of necrosis on the surface of the upper eyelid and infection data, surgical management was initiated with debridement, systemic antibiotic therapy and negative pressure system device, once the infectious process was resolved and according to the principles of reconstruction by aesthetic subunits, it was decided to reconstruct 100% of the subunit affected by a skin graft of total thickness of the contralateral eyelid through a blepharoplasty with good aesthetic-functional results. The reconstruction of the eyelids should be managed by a plastic surgeon, taking into account the principles of the aesthetic subunits, optimally the donor tissue should have similarity with the tissue to be reconstructed, with respect to the size, color and flexibility, to obtain an adequate aesthetic and functional result.


Blepharoplasty, Palpebral reconstruction, Functional surgery, VAC system, Full thickness skin graft

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Subramanian N. Reconstructions of eyelid defects. Indian J Plast Surg. 2011;44(1):5.

Lin L, Martin J. State of the Art in Congenital Eyelid Deformity Management. Facial Plast Surg. 2016;32(02):142–9.

Espinoza GM, Prost AM. Upper Eyelid Reconstruction. Facial Plast Surg Clin N Am. 2016;24(2):173–82.

Morley AMS, deSousa J-L, Selva D, Malhotra R. Techniques of Upper Eyelid Reconstruction. Surv Ophthalmol. 2010;55(3):256–71.

Bhattacharjee K, Misra D, Deori N. Updates on upper eyelid blepharoplasty. Indian J Ophthalmol. 2017;65(7):551.

Mathijssen IMJ, van der Meulen JC. Guidelines for reconstruction of the eyelids and canthal regions. J Plast Reconstr Aesthet Surg. 2010;63(9):1420–33.

Takahashi Y, Mito H, Nakamura Y, Kakizaki H. Upper Eyelid Reconstruction by Making a Skin Defect Similar to Skin Removal in Blepharoplasty. J Craniofac Surg. 2014;25(5):e445–6.

Tuncali D, Ates L, Aslan G. Upper eyelid full-thickness skin graft in facial reconstruction. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2005;31(1):65–70.

Meissner M, Hofmann W, Kaufmann R. Reconstruction of the upper eyelid: full-thickness skin grafting between the same contralateral aesthetic units. JDDG J Dtsch Dermatol Ges. 2016;14(3):319–20.

Russo F, Linares M, Iglesias ME, Martínez-Amo JL, Cabo F, Tercedor J, et al. Técnicas reconstructivas de elección por unidades estéticas faciales. Actas Dermo-Sifiliográficas. 2017;108(8):729–37.

González-Ulloa M. Regional aesthetic units of the face. Plast Reconstr Surg. 1987;79(3):489–90.