Eyelid Reconstruction
After skin cancer removal on the eyelid or surrounding face, careful reconstruction restores both function (protecting the eye, blinking, tear drainage) and appearance. This is reconstructive work that belongs to the oculofacial specialty.
The eyelid is one of the most anatomically demanding regions in the body to reconstruct. It is built in layers (skin, muscle, tarsus, muellers, conjunctiva) each of which has to be replaced for the lid to close properly, blink, distribute the tear film, and look natural. After Mohs surgery for basal cell carcinoma, melanoma, sebaceous cell carcinoma, or squamous cell carcinoma on the eyelid, brow, or cheek, the resulting defect can range from a small skin gap to a full-thickness loss of part of the eyelid margin.
Dr. Boxrud reconstructs eyelid defects across this full spectrum. The technique is chosen for the specific defect: direct closure, skin grafting, local flaps, or composite reconstruction that rebuilds the lid in its proper layers. The goal is a bring back the anatomical function of the eyelid.
Most of these cases are referred directly from Mohs dermatologists or ophthalmologists across the Los Angeles area, who specifically send periocular cases to an oculoplastic specialist rather than reconstructing in their own clinic. The reconstruction is typically performed within a day or two of the cancer removal.
- Coordination
- Reconstruction is scheduled in close coordination with the Mohs dermatologist, usually the same day or the day following cancer removal.
- Anesthesia
- Local with sedation; general anesthesia for larger defects.
- Recovery
- Variable; sutures are typically removed within 5 to 10 days. Healing of the lid margin can take several weeks to settle.
What is eyelid reconstruction?
Eyelid reconstruction is the surgical rebuilding of the eyelid after tissue has been removed or damaged. It is most commonly needed after skin cancer removal (often by Mohs surgery), trauma, or congenital deformity. The goal is both functional protection of the eye and a natural cosmetic appearance.
When is eyelid reconstruction needed?
Most often after Mohs surgery for skin cancer involving the eyelid. Eyelid skin cancer is common, and once the cancer is removed, the resulting defect must be reconstructed by a surgeon with specialized oculofacial training.
What is Mohs surgery?
Mohs surgery is a precise skin cancer removal technique that takes the cancer out in stages, checking the margins under the microscope at each step. It preserves the maximum amount of healthy tissue but leaves a defect that needs reconstruction. The Mohs surgeon and the reconstructive surgeon are usually two different specialists working together.
How is the eyelid reconstructed?
The technique depends on the size, depth, and location of the defect. Options range from direct closure for small defects to local skin flaps and grafts for larger ones. Dr. Boxrud has decades of experience with the full range of eyelid reconstructive techniques.
How long is recovery?
Most patients return to non-strenuous activity within 7 to 10 days. The final appearance continues to settle over several months. Revision can be planned later if needed.
Will I have visible scars?
Some scarring is unavoidable after reconstruction, but it fades dramatically over months and is designed to follow natural skin lines for the most discreet result. Dr. Boxrud’s reconstructive technique prioritizes both eye protection and cosmetic outcome.
Is eyelid reconstruction covered by insurance?
Typically yes. Reconstruction after cancer or trauma is medically necessary and is generally covered by insurance.