Eyelid Reconstruction | Ophthalmology | Loyola Medicine

Eyelid Reconstruction after Skin Cancer Removal or Trauma

Overview and Facts about Eyelid Reconstruction after Skin Cancer Removal or Trauma

Eyelid reconstruction after skin cancer removal or trauma is an ocular procedure in which the doctor rebuilds the eyelid, after part of it has been removed or damaged.

Signs and Symptoms of Eyelid Reconstruction after Skin Cancer Removal or Trauma

Skin cancer is very common in general, and the eyelid is a common place that skin cancer is found. People with cancer on the eyelid may experience the following signs or symptoms:

  • A difference in the appearance of the skin on the eyelid
  • Swelling or thickening of the eyelid
  • Chronic infection of the eyelid
  • A wound on the eyelid that does not heal
  • A colored mass on the eyelid that grows
  • New bumps or moles around the eyelids or on the face

Causes and Risk Factors of Eyelid Reconstruction after Skin Cancer Removal or Trauma

The need for eyelid reconstruction surgery generally comes from cancer or a trauma, such as a car accident or a bad fall.

The most common eyelid skin cancer is basal cell carcinoma, followed by squamous cell carcinoma and sebaceous cell carcinoma. Melanoma is also seen, but not as common as basal cell carcinoma and other forms of cancer.

Causes and risk factors for skin cancer on the eyelid include:

  • Exposure to UV radiation
  • Having fair skin
  • Gender (more common among males)
  • Age (more common in people older than 50)
  • A history of sunburns or generally frail skin
  • Having skin cancer previously
  • Having precancerous skin lesions like red or brown scaly patches

Tests and Diagnosis of Eyelid Reconstruction after Skin Cancer Removal or Trauma

Skin cancer on the eyelid, like most other cancers, is best diagnosed with a biopsy. A biopsy involves the doctor taking a sample of the tissue and testing it definitively for cancer. If a biopsy is not possible due to another factor like age or previous test results, the doctor may suggest other tests that will help make a diagnosis, including imaging tests. Imaging tests may be used to find out whether cancer has spread.

Treatment and Care for Eyelid Reconstruction after Skin Cancer Removal or Trauma

There are a few different treatment options for eyelid reconstruction. Deciding which is the most appropriate depends on a few factors, such as:

  • How old you are and the extent of the damage
  • The amount of tissue missing after the skin cancer is removed
  • Location of the defect (upper lid, lower lid, or medial lid) and whether or not the defect caused a tear in the tear duct

The most common treatment technique is called Mohs surgery, which is a microscopically controlled surgery that limits the amount of damage done to healthy parts of the eyelid. The surgery can typically be done in an office with just local anesthesia, but if the defect is large or if there is a tear in the duct, general anesthesia and a visit to an operating room may be required.

Reconstruction occurs after Mohs surgery is complete. Grafting techniques, which involve using tissue from the other eyelid or the skin from behind the ear, can effectively be used to rebuild a new eyelid.