Background: In consideration of the distinctive structural characteristics of the eyelid, the optimally matching donor site to the original recipient site skin should be selected when a full-thickness skin graft is anticipated in a small-sized or medium-sized eyelid defect in middle-aged or elderly patients.
Methods: Eight patients ranging in age from 47 to 71 years suffered singular eyelid defects of different causes. Based on the location, shape, and degree of the defects, we removed the redundant skin as a skin graft from the same side in the contralateral eyelid in a routine blepharoplasty procedure and transferred the graft to repair the defect.
Results: The skin grafts survived in all cases, and the incisions healed primarily. The eyelid laxity improved, and no complications occurred. All cases were followed up for 3 months to 2 years, the quality of skin grafts was similar to that of the surrounding skin, and the activity was ideal.
Conclusions: When an eyelid defect is not amenable to direct closure and skin grafting is selected, the proper donor site is vital to the final outcome. The same facial aesthetic subunits, such as sufficient laxity in the contralateral eyelid skin in middle-aged and elderly patients, can provide the best match with the recipient skin and represent the best donor site for defect reconstruction.