Benign and malignant tumors of the eyelids/eyelid area

For small tumors, a biopsy is taken first. This requires a short outpatient procedure. The material is sent to a laboratory and examined under a microscope to confirm the diagnosis. In a second operation, the tumor is removed.

For large tumors, the tumor is removed with a safety margin. This often requires general anesthesia. This is followed by a frozen section diagnosis, i.e. the pathologist immediately examines the removed material under the microscope and informs us 1-2 hours after removal whether the cut edges are free of the tumor. Subsequently, the reconstruction of the eyelid is performed in a second operation on the same day.
 

After removal of the tumor and frozen section diagnosis, the eyelid can be reconstructed. There are a variety of surgical options for eyelid reconstruction. In general, eyelid reconstruction has made tremendous progress in the last 2 decades. Previously, large plastic surgeries of the entire midface were performed to replace one eyelid, or even the eyelids and eye were removed entirely. Fortunately, thanks to improved techniques, this "radical" surgery is no longer used in the vast majority of cases.

Nowadays, defects of all sizes up to complete eyelid replacements can be covered by material originating from the area around the eyelids. Which method is used depends on how much eyelid needs to be removed, i.e. how large the defect to be covered is. Modern surgical techniques range from direct closure to grafts of skin, muscle or connective tissue sheets taken from the upper/lower eyelid of the same side or from the eyelids of the other, healthy eye.

In rare cases, skin is necessary, which is taken from behind the ear.

In some of the modern procedures it is also necessary to operate on two sides: the eyelid is reconstructed and the eye cannot be opened for about 10 days. Then another (short) operation is performed to complete the reconstruction.

The priority in tumor surgery of the eyelids is that the carcinoma is completely removed. Of course, cosmetics are also taken into account, but the former is vital, the latter is not. In the case of large tumors, it may have to be expected that even after successful surgery, the eyelid will not look exactly as it did before surgery.

If a skin graft is required, the graft may also have a different shade than the surrounding skin as a long-term consequence.

Even after complete removal of the carcinoma, there is still a risk of its recurrence years after surgery. Please be prepared for the fact that in the first 3 years after the operation, 6-monthly check-ups with us will be necessary. Later, the intervals between the controls can be increased.