Publication:

Reconstruction of the upper eyelid ciliary margin using an eyebrow hair-bearing Fricke flap in a young patient: a case report

Traumatic loss of upper eyelid tissue presents a dual challenge—restoring the delicate mechanics of eyelid function while recreating the subtle aesthetic harmony of the periocular region. We report the reconstruction of a lateral upper eyelid defect in an 18-year-old male following traumatic avulsion, approached with an emphasis on both protection and appearance. A temporally based forehead (Fricke) flap was thoughtfully designed to incorporate a linear array of eyebrow hair follicles, allowing not only resurfacing of the defect but also recreation of a natural-appearing lash line. This was complemented by meticulous posterior lamellar repair and lateral canthal stabilization for structural integrity. This reconstruction achieved stable eyelid position, complete and comfortable eye closure, and pleasing aesthetic contour with restoration of the lash margin. This case highlights the versatility of the Fricke flap, demonstrating how, when adapted with aesthetic intent, it can seamlessly unite function with form in selected traumatic eyelid defects.