ABSTRACT
When repairing soft tissue defects of the eyelids that do not involve the eyelid margins, the general principles of skin reconstruction must be modified so that the eyelid function is properly preserved. For instance, a defect in the lower lid might be closed in a horizontal manner so as to hide the scar within a line of facial expression. However, if the defect is greater than the amount of available skin, this type of repair might result in lower lid ectropion. Ectropion of the upper lid is less likely to occur following a horizontal closure since upper lid skin is usually more plentiful. Tarsal kinking can occur in either the upper or lower lid if a vertical closure is done without sufficient attention to the effect on the tarsus.
