A Case of Posterior Lamella and Eyelid Margin Reconstruction Using Conchal Cartilage With Overlying Skin for Full-Thickness Lower Eyelid Defect

Reconstruction of large full-thickness lower eyelid defects requires restoration of both anterior and posterior lamellae. A common challenge is achieving a natural eyelid margin without thickening. Herein, the authors describe the case of an 82-year-old man with basal cell carcinoma of the right lower eyelid. Tumor resection resulted in a full-thickness defect involving more than half of the medial lower eyelid. Reconstruction was performed using a skin-bearing conchal cartilage graft for the posterior lamella and marginal anterior lamella, combined with an angular flap for the remaining anterior lamella. Despite partial epidermal necrosis of the grafted skin, a natural appearance was achieved by 6 months postoperatively without eyelid closure issues or corneal complications. This technique avoided eyelid margin thickening and yielded good aesthetic and functional outcomes. Although further improvement is needed to ensure reliable graft vascularization, the method is a promising reconstructive option for large lower eyelid defects from both cosmetic and wound-healing perspectives.