Tarsal-Conjunctival Graft or Flap and Skin-Muscle Transposition Flap in Lower Eyelid Reconstruction

  • Behin BarahimiEmail author


Lower eyelid reconstruction requires multiple tools in an oculoplastic surgeon’s armamentarium. Although the tarsoconjunctival (Hughes) flap is reliable, the requirement of a second stage and closure of the eye are definite disadvantages to the procedure. In addition, some defects are in the gray zone between a primary closure with cantholysis and a Hughes flap. This chapter describes two different one-stage procedures for reconstruction of large full-thickness defects of the lower eyelid: one procedure employs a free tarsal graft, while the other uses a laterally based tarsoconjunctival flap.


Lower eyelid reconstruction Free tarsal graft Periosteal flap 

Supplementary material

419986_5_En_38_MOESM1_ESM.mp4 (74.2 mb)
Video 38.1 Free tarsal graft harvest. Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 76000 kb)
419986_5_En_38_MOESM2_ESM.mp4 (279.5 mb)
Video 38.2 Repair of 50% lateral full-thickness lower eyelid defect. Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 286168 kb)

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Clinical Ophthalmology, Department of OphthalmologyVanderbilt UniversityNashvilleUSA

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