We report a single-stage reconstruction of an extensive full-thickness lower eyelid defect using an angular artery–based transposition flap without discrete posterior lamella repair. Despite involvement of approximately 80% of the lower eyelid, the well-vascularized flap provided sufficient structural support and achieved excellent functional and cosmetic outcomes at one-year follow-up. This approach may represent a minimally invasive alternative for carefully selected periocular defects.
Higuchi et al. (Wed,) studied this question.