LETTER TO THE EDITOR The Effect of W-plasty on Cheek Rotation Flap

Dear Sir, Cheek rotation flaps1-3 are used to reconstruct lower eyelids. After rotating the flap, the suture line on the cheek is not aligned with a relaxed skin tension line, and postoperative scars that intersect the margin of the lower eyelid at angles close to 90 ̊ may cause downward contractures of the lower eyelid. We describe herein 2 cases in which we avoided this problem by using w-plasty when suturing the cheek rotation flaps to the remaining eyelid and cheek skin in reconstructions, following Meibomian adenocarcinoma resections. Case 1: The Mustardé method was used to reconstruct the left upper eyelid of a 74year-old woman after a Meibomian adenocarcinoma was resected. Two weeks after the first operation, the switch flap was detached and w-plasty was performed to close the flap donor site. Two years postoperatively, there was no pronounced scarring and the lower lid had not evinced any contractures due to the suture line (Fig 1).