Composite Advancement Flap (Cutler-Beard Procedure)
The Cutler-Beard procedure is indicated in reconstruction of large defects of the upper eyelid. Typically, defects of more than 60% of the eyelid require repair with this two-stage reconstruction using full-thickness tissue from the lower eyelid. In the first stage, a full-thickness flap from the lower eyelid is advanced posterior to an intact lower eyelid margin. This includes the conjunctiva of the lower fornix, deep tissue of the lower eyelid, and skin. It attains collateral vascularization and lengthens over a period of 3–8 weeks. In the second-stage, the flap is divided at the level of the palpebral fissure, and the lower eyelid is reconstructed. The fornices are moderately foreshortened after this procedure.
KeywordsUpper eyelid defect Composite advancement flap Cutler-Beard procedure Two-stage advancement flap Bridge flap