Procedure: fter MOHS surgery this young patient did not have enough tissue to close the defect. I chose to do a Hughes flap which is a tarsoconjunctival graft. That means I borrow a connected portion of tarsus and conjunctiva from the upper lid. It maintains its old blood supply while it develops a new blood supply in its new location. I then place a skin graft from behind the ear to replace the skin defect. 4-6 weeks later I divide the eyelids. This is an advanced procedure and requires very fine, delicate work.

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