Options for eyelid reconstruction after MOHS surgery? (Photos)

Question

Hi all. I had MOHS surgery on a BCC skin cancer on my eyelid this year followed by Hughes flap reconstruction. I have attached photos, but basically I'm really disappointed with the results of the reconstruction and how I look. I had the reconstruction done at Moorfields Eye Hospital in London, one of the best hospitals in the country.She warned me the complications could include red/pink skin on eyelid, notches, drooping eyelid, and lucky me it looks like I got all 3. My main worry is the obvious drooping or shape of the reconstruction. When I compare my eye now to a few months ago there is evident change in the shape of my eye, and it's very obvious one eye now almost looks bigger than the other due to this. At my last checkup my surgeon advised me to leave the healing a while to see how it heals, but it's obvious to me its not going to get better. She did always say there would be an option of another surgery to correct the shape, however she has tried to put me off slightly. I am here looking for professional second opinions on the work on my eye, what can I hope to achieve from a 2nd surgery, any advise basically. I have see a lot of similar surgeries here which have much better cosmetic outcomes than my own and it makes me sad and worried my eye will never look as good again. I'm youngish, M 35. I had all my surgeries in Feb 2025, so it's been 8 months.

Erik Peterson, MD · Answer

After a Hughes flap reconstruction, it’s very common to have asymmetry, changes in eyelid shape, redness, drooping or notches because the eyelid and flap heal slowly and scar tissue can pull the lid in different directions. Many patients have minor irregularities at first and some need secondary refinement later.
At 8 months out, some healing is still ongoing but most of the major swelling and scar contraction has settled, so if the shape and position still look clearly different and that bothers you, a revision with an experienced oculoplastic surgeon is a valid option. Surgeons often wait around 6–12 months so the tissues soften and they can clearly see what needs adjusting before a revision. 
Revision surgery can improve eyelid contour, droop and asymmetry, but the exact outcome depends on the scar pattern and your anatomy. A second opinion from an oculoplastic surgeon who specializes in eyelid reconstruction and revision can help you understand what changes are realistic and what techniques they’d use to refine the shape while maintaining function. 
In short: it’s not unusual for complex eyelid reconstructions to need a later revision for cosmetic refinement, and a specialist evaluation will give you a clear sense of what can be improved and how.
NYC has a great number of specialist occuloplastic surgeons who I would recommend

Options for eyelid reconstruction after MOHS surgery? (Photos)

Answers (1)

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