For skin grafts in the upper eyelids after too much skin removal, would partial or full thickness grafts be used?

Question

To cure lagophthalmos from over-excised skin.

Trevor M. Born, MD · Answer

Dear eyelid123Thank you for your question!  There are multiple options to help with eyelid closure- shaping of the brow, botox to brow elevators, time to allow skin relaxation, tarsorrhaphy, and fillers.A consultation would be helpful in giving a good opinion.  The skin graft typically is a full thickness type and harvested from an area where the skin is very thin- to match the eyelid skin.  Sometimes more than one procedure is needed in this type of surgery.With Warm RegardsTrevor M Born MD

Kenneth D. Steinsapir, MD · Answer

Again, your issues may not resolve with lengthening of the eyelids.  I suspect that your issues is loss of motor nerve function to the upper eyelid orbicularis.  This means that the eyelid muscle that closes the eye and blinks the eye does not generate enough force to do this effectively.  Be careful of talking yourself into corrective surgeries that are not going to work.

Stephen Weber MD, FACS · Answer

Eyelid reconstruction would typically be performed with a full thickness graft. This is done to minimize how much the graft contracts/ shrinks as well as to create better color/ texture match with your native eyelid skin. Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Mark D. Wigod, MD · Answer

Most of the time, and especially for an eyelid, a skin graft on the face would be full thickness.  FTSG's have less contraction than split (STSG) and may be harvested behind or in front of the ear with good color match. A FTSG may have a more difficult time with take and may not be used when there is a large area to be covered or if the coverage is to be temporary before a revision.

Scott W. Vann, MD, FACS · Answer

If an eyelid graft is needed then a full thickness graft is used to minimize post op contraction of the graft. The graft is best taken from the upper portion of the body to give the best color match. Two common sites are behind ear and neck.

John J. Martin, Jr., MD · Answer

Are you sure you don't have enough skin?  Can you manually close your eyes with your fingers?  If you can you have enough skin but the muscles don't work correctly .  Usually nerve issue.  If you can not manually close would need skin graft.

Erez Sternberg, MD · Answer

The only way to cure this problem is to excise the prior scars and place a full thickness skin graft over the levator muscle. Ensure at least 8mm of tarsal plate are present and weren't accidentally excised.

John R. Burroughs, MD · Answer

These are full-thickness.  The partial thickness have a tendency to shrink too much.  Good sites are other areas of eyelid skin if they remain, from in front/behind the ear, near where the shoulders meet the neck, and inner aspect of upper arms.  Best regards.

Kevin L. Smith, MD, FACS (retired) · Answer

When skin grafts are required to correct a too aggressive skin removal during blepharoplasty surgery, a thin full thickness graft is generally used. This skin is harvested from around the ear or the neck to provide the best color match. A full thickness skin graft will not contract as much as a split thickness skin graft and it generally provides a better result. Good luck.

For skin grafts in the upper eyelids after too much skin removal, would partial or full thickness grafts be used?

Answers (9)

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