Treatment of xanthelasma palpebrarum by upper eyelid skin flap incorporating blepharoplasty.

BACKGROUND: Wound repair after xanthelasma palpebrarum excision in the upper eyelid is a challenge for the plastic surgeon due to the difficulty obtaining tissue of the appropriate color and texture. The authors present their treatment of xanthelasma palpebrarum by an upper eyelid skin flap incorporating blepharoplasty with satisfactory results for 16 patients.

METHODS: From September 2004 to August 2012, 32 xanthelasma lesions in the upper eyelids of 16 patients were surgically excised, after which an orbicularis oculi muscle myocutaneous flap was formed in blepharoplasty. The flap was used to repair the defect resulting from excision of the lesion. The xanthelasma palpebrarum treatment and blepharoplasty were performed simultaneously.

RESULTS: No flap necrosis complications occurred after the operation. During a 3- to 12-months follow-up period, no lesion recurrence, lagophthalmos, hypertrophic scar, or bulky appearance was noted in any of the 16 patients. Aesthetic results in the upper eyelid were obtained for all the patients.

CONCLUSION: By the reported method, the "waste" skin in blepharoplasty can become "treasure" material for covering the defect resulting from lesion excision. No new donor area is required. The dual effects are excision of the xanthelasma lesion and a satisfactory cosmetic result in the upper eyelid. This procedure could be the preferred option for xanthelasma palpebrarum in the upper eyelid.