PurposeA primary defect in the eyelid resulting from tumor excision will benefit from better skin match when the defect is repaired with eyelid skin. The amount of skin harvested by blepharoplasty from a single upper eyelid may be inadequate. This report describes and evaluates the effectiveness of two types of procedure in which maximal eyelid skin is harvested to repair defects in the upper or lower eyelids, respectively. The techniques require the resulting secondary defect being partially replaced by a second graft taken from the contralateral upper eyelid.MethodsThe surgical results of a prospective case series are evaluated. Postoperative upper eyelid graft appearance and patient satisfaction were recorded.ResultsTen patients underwent repair of a large skin defect in the upper eyelid (2 patients) or lower eyelid (8 patients), using maximum upper eyelid skin from above the skin crease. The primary donor site upper eyelid defect was closed after partial secondary grafting with skin from the side contralateral to the upper eyelid from which the maximal graft was taken. All patients were satisfied with the appearance of the grafted and donor areas.ConclusionsMaximal eyelid donor skin harvesting achieved satisfactory results and is a useful technique in eyelid reconstructive surgery.