canthal defects

The bipalpebral flap (BPF) consists of two cutaneous flaps-a sliding flap from the lower lid and a rotating flap from the upper lid. These skin flaps are dissected from the orbicularis muscle with careful coagulation of all tiny bleeding vessels. Skin flaps were preferred to myocutaneous flaps because they allow a simpler surgical procedure. The principal advantage of this technique is that it minimises the size of the associated repair, decreases the size of the skin graft in large defects, and uses adjacent skin of similar appearance and thickness to that lost from the defect. We report our experience with the BPF, an underused but effective technique to repair medial or lateral canthal defects, using both upper and lower lid skin. We believe the BPF was first reported on by Brun and Morax' in 1899, but since that time the technique has been forgotten.