Application of free full-thickness skin graft combined with periocular cosmetic surgery in the treatment of periocular masses

Objective To investigate the effect of free full-thickness skin graft combined with periocular cosmetic surgery in the treatment of periocular masses.Methods A total of 11 patients who were admitted to Department of Plastic Surgery, the Affiliated Hospital of Xuzhou Medical University from September 2018 to December 2021 were selected. All the patients had periocular masses, including xanthoma, melanin nevus, accompanied by upper or lower eyelid skin relaxation, with the intention of double eyelids. After surgical removal of the masses, the patients underwent periocular cosmetic surgeries according to their corresponding conditions to obtain a free full-thickness skin graft around the eyes. Free full-thickness skin graft was designed according to the size of defect. After six months of follow-up observation, postoperative scars in the skin graft area were scored by the patient and observer scar assessment scale(POSAS) and patient satisfaction was evaluated using a self-made patient satisfaction questionnaire.Results There were 13 masses in 11 patients. The maximum mass was 2.1 cm × 1.4 cm and the minimum was 1.2 cm × 0.6 cm. After follow-up observation of 6 months, the skin graft survived well, with soft texture. There was no significant difference in color with the surrounding skin. The eyelids, eyebrow lifting and pouch looked natural and beautiful. The POSAS scores indicated that surgeons were satisfied with the scar in the skin graft area, and one patient felt that the scar in the skin graft area was thick. The patient satisfaction rate was 90.9%.Conclusions The free full-thickness skin graft obtained from periocular cosmetic surgery such as double eyelid plasty, eyebrow lifting and pouch plastic surgery is similar to the surrounding normal skin in terms of the texture and color. It is a good skin donor area for periocular defects. With the removal of the periocular masses, the periocular region was improved in appearance, achieving periocular rejuvenation.