In the upper eyelid, the large skin defect that cannot be repaired primarily is usually covered with skin graft.
But the rigidity of the grafted full thickness skin make the superior palpebral fold at the higher level along the upper margin of the graft than the opposite side.
In this paper, we would like to correct this asymmetry by using tissue expander.
Nowadays, the tissue expander became the one of the most popular technique in the field of plastic and reconstructive surgery since it was introduced in 1976 by Rodovan.
Although numerous reports on both the clinical and experimental experiences have been advocated, there still remain certain problems on its accurate indication and standard techniques for promising good results. Futhermore, the clinical application of tissue expander on the upper eyelid was seldom introduced.
To insert the prosthesis, the skin incision was made just beneath the upper margin of the grafted skin. The prosthesis was placed under the muscle layer in order to decrease the risk of implant exposure and then reservoir dome was placed in ipsilateral temporal area. Two
weeks after prosthesis placement, the serial inflation was made by small amount and short interval for 3 weeks(0.3-0.4cc/time, 2 times/week)to avoid eyeball compression.
After adequate expansion was completed, the expander was removed. The grafted skin was excised to the same level of the opposite normal fold and the expanded normal skin above the grafted skin was advanced inferiorly. And then the graft area was confined below the normal height of palpebral fold.
Therefore, the asymmetry of both upper eyelid was corrected satisfactorily.
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