Reconstruction of Divided Eyelid Nevus Using an Expanded Forehead Flap Supplied by the Supratrochlear Artery

PURPOSE: Divided eyelid nevi pose significant challenges for affected individuals. Traditional surgical options often result in a suboptimal color or texture match. This study evaluates the outcomes of using an expanded forehead flap for the reconstruction of these complex defects. METHODS: Between 2013 and 2024, 7 patients with divided eyelid nevi underwent staged reconstruction with an expanded forehead flap. The surgical technique involved 3 stages: (1) insertion and inflation of a tissue expander in the supraeyebrow region; (2) transfer of the expanded flap to the periorbital defect following lesion excision, with the flap pedicled on the supratrochlear artery; and (3) 3 weeks postoperatively, axial vessel ligation was performed for flap delay, followed by pedicle division and defect repair 1 week later. Clinical data, surgical details, and outcomes were recorded and analyzed. RESULTS: All 7 flaps survived completely. Flap sizes ranged from 3.0×3.0 to 10.0×10.0 cm. Minor complications included 1 case of wound dehiscence near the expander port, which healed with conservative management. No cases of flap necrosis, venous congestion, brow ptosis, or ectropion were observed. The color, texture, and thickness of the flaps showed an excellent match with the recipient site. One patient underwent subsequent flap thinning for perceived bulkiness. During a follow-up period of 3 to 24 months, all patients expressed satisfaction with both the aesthetic and functional outcomes. CONCLUSIONS: The expanded forehead flap based on the supratrochlear and supraorbital vessels is a reliable and effective technique for reconstructing divided eyelid nevi.