Purpose

We present the use of the graft over graft technique in eyelid reconstruction, highlighting its functional and aesthetic effectiveness as an alternative to traditional techniques.We present this technique as an alternative for those cases where a graft over a flap is not possible.

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Methods

A 86-year-old woman presented with a nodular lesion in the central third of her right lower eyelid. Biopsy revealed basal cell carcinoma. En bloc excision of the tumor with clear margins was performed, followed by reconstruction using a tarsal graft and a skin graft from the contralateral upper eyelid.

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Results

The graft-on-graft technique offers single-stage repair, preserving the visual axis and achieving good aesthetic and functional results. The eyelid, due to its thinness, vascularization, and anatomical support, favors graft integration, unlike other areas of the body.

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Conclusion

A key limitation is the need for an adequate vascular bed around the graft. Future studies should define the maximum treatable defect size.The graft over graft is a safe and promising technique for eyelid reconstruction, whose potential will continue to expand with more clinical evidence.

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Additional Authors

First name	Last name	Base Hospital / Institution
Tamara	Palenzuela Alavarez	Hospital Universitario Fuenlabrada
Natalia	Monja Alarcon	Hospital Universitario Fuenlabrada

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