Several methods of lower eyelid reconstruction have been reported, including rotation cheek flaps (1, 2, 3), musculocutaneous orbicularis flaps (4), partial- or full-thickness upper eyelid flaps (5, 6, 7, 8, 9), nasolabial and supraorbital flaps (10), and full-thickness skin grafts for coverage (11). These have been combined with conjunctival flaps and chondromucosal grafts for lining (11, 12).

Using the reliable V-Y advancement principle described by Gillies (13) [later modified to an island subcutaneously based by Kutler (14) in fingertip reconstruction] and the triangle of cheek skin discarded during reconstruction in the Mustardé cheek rotation skin flap (3), the lower eyelid can be reconstructed by covering a chondromucosal graft with a V-Y advancement cheek flap (15).