The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.



Tenzel flap for lower lid reconstruction

Photo by Professor Chua

This patient had a lower eyelid basal cell carcinoma which was confirmed on biopsy. The lesion involved the full thickness of the eyelid. The lesion was excised with 3mm free margin. The defect was reconstructed using Tenzel's flap.


Left lower eyelid basal cell carcinoma.


Markings of pentagon excision and Tenzel flap were marked.


The tumour was excised with 3mm free margin. About 50% of the lower eyelid was excised.


A Tenzel flap consisting of myocutaneous tissue was fashioned.


The cut edge of the lower eyelid was sutured to the myocutaneous flap.


The lateral canthal angle was formed using 6/0 Vicryl by suturing the myocutaneous tissue to the lateral margin of the upper eyelid. 4/0 silk was used in places to secure the wound.


The appearance of the eye 24 hours later. There was chemosis.

Atlas of Oculoplastic Surgery