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Three cases of single stage, bi-lamellar reconstruction of full-thickness, horizontal, lateral three quarter lower eyelid defects using pedicled island flaps of adjacent vascular territories and hard palate muco-periosteal graft are being presented. All cases were done for Basal Cell Carcinoma of the region. While the island flaps allowed for a simple, single stage reconstruction of the external lamella, the hard palate muco-periosteal graft, by virtue of its inherent resilience and a rich glandular component, took well and provided for a good functional and aesthetic result. The follow-up ranged from 6 to 40 months and the final result has been oncologically, functionally and aesthetically satisfactory.

Bi-lamellar lower eyelid reconstruction with superficial temporal artery island flap and hard palate muco-periosteal free graft