Modified cutler-beard flap in upper eyelid reconstruction

Abstract

Introduction: The Cutler – Beard flap is a Plastic Surgery technique used for reconstruction of large upper eyelid (UE) defects, The technique consists of a flap from the lower eyelid (LE) conjunctiva. It’s common complications are entropion and retraction. In order to minimize such complications the surgeons have modified the technique by placing an auricular cartilage graft.
Objective: Evaluate the anatomical and functional results of the modified technique.
Case report: Male patient, 19 years old, with complex and late injury in his eyebrow and right upper eyelid. He underwent reconstruction in three surgical times. Firstly, the plastic surgeons promoted a release of the retraction and an extension of the UE. The patient was not able to completly close his eyelids yet. So the surgeons opted for the Cutler – Beard technique, which occurs in another two surgical times.
Discussion: The UE reconstruction is complex and defiant. The choice of technique depends on the extention of the eyelid injuries. The CutlerBeard technique with a cartilage graft provided an increased stability to the UE. The skin flap with similar texture and colour provides better aesthetic results than the original Cutler –Beard.