Skin lesions on the eyelids are very common. Most of them are benign, but it should be borne in mind that the eyelids are the most common site for skin cancers, especially basal cell carcinomas, so it is very important to be assessed by a specialist if any new lesion grows on the eyelids.

Benign lesions can be removed for aesthetic reasons, as the eyes are the place where we always look when we interact with other people, so they do not usually go unnoticed. They can always be removed under local anaesthesia and without complications. Special care must be taken with those that appear near the tear ducts to avoid damaging them during surgery.

Malignant lesions must always be removed, as they can be life-threatening. If basal cell carcinomas are completely removed, they rarely recur and do not metastasise, so they can be considered cured. Other malignant tumours, such as squamous cell carcinomas or sebaceous carcinomas, do have a risk of recurrence and distant metastasis, so early diagnosis is very important in order to treat them as soon as possible.

In the surgery of malignant eyelid tumours, the main criterion is oncological, i.e. to remove the entire tumour. One should not be conditioned by the fear of a more difficult reconstruction at a later stage. In many cases it is also recommended to perform Mohs surgery or edge control during surgery to ensure that the tumour is removed in its entirety before reconstructing the defect that has been caused. The second criterion is functional, i.e. to ensure that the eyelids close properly and the eye is protected and does not dry out. And finally, the third criterion is aesthetic. This means that the functionality of the eyelid should not be sacrificed for a better aesthetic result. However, with current reconstruction techniques, the results are usually functionally and aesthetically very good.

The order of priority in surgery for malignant eyelid tumours is:

  • Removing the entire tumour
  • Achieving a functioning eyelid that closes properly
  • To achieve the most aesthetically favourable result possible


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