Eyelid skin cancer is common among older patients, especially those with fair skin and individuals who exposed themselves to much ultraviolet light in their lifetime, for example, surfers and farmers. Skin cancer is especially prevalent in the inner angle of the eye (medial canthus) and the lower lid, but it may originate in any location around the eyes.
Basal cell carcinoma is the most common carcinoma affecting the periocular region. This type of skin cancer grows slowly, invading the skin and muscle. It starts as a reddish-pink bump on the skin with irregular borders, and in some cases, loss of eyelashes and skin ulceration.
When eyelid skin cancer is small in size, it may be excised using a technique called pentagonal wedge resection. This simple procedure consists of extracting the lesion and closing the layers of the eyelid. It is done in a minor procedure room under local anesthesia.
However, when the cancer is more extensive or is poorly defined, a larger excision is necessary and may require the removal of a significant portion of the lid. In these situations, the eyelid reconstruction can be very complex, requiring flaps and grafts to recover normal eyelid function and achieve a reasonable aesthetic outcome.
Oculoplastic surgeons are eye surgeons that have specialized in plastic and reconstructive eyelid operations. As such, they are accustomed to performing complex eyelid reconstructions after the removal of skin cancer. Their first goal when performing a reconstructive procedure is to preserve the health of the eye. Eyelid surgeons also aim to restore complete eyelid function. Finally, oculoplastic surgeons always seek to reach the best aesthetic outcome in each reconstruction.