Cicatricial iatrogenic lower eyelid malposition in skin cancer surgery: results of a combined approach

Purpose: Malposition of the lower lid, including rounding of the lateral canthal angle, lower eyelidretraction with inferior scleral show, and ectropion, is a relatively frequent complication in the surgicaltreatment of skin cancer of the cheek and zygomatic areas. The tarsal strip technique, in association witha vertical vector cheek lift, is a reliable method for correcting lower lid malposition.Materials and patients: From January 2008 to January 2010, we treated 19 patients with lower eyelidmalposition after skin cancer surgery of the cheek and zygomatic areas. To correct lower eyelidmalposition, we used the tarsal strip technique and a vertical vector cheek lift in all patients.Results: Eleven patients had scleral show and eight patients had ectropion. Sixteen patients obtainedsatisfactory correction of the eyelid malposition in a single surgical procedure, while three patientsrequired a second surgical step to correct the remaining scleral show. Good esthetic and functionalresults were achieved in all cases.Conclusions: The surgical treatment of skin cancer of the cheek and zygomatic areas has the potential forpostoperative sequelae. The tarsal strip technique, in association with a vertical vector cheek lift, isa relatively simple technique for correcting scleral show and ectropion.