In the last 10 years. Mohs' fresh-tissue surgery has been increasingly employed for the treatment of extensive basal cell carcinomas and other malignancies of the eyelids. Large defects after Mohs' surgery for these lesions may involve the nose, cheek, forehead, and other parts of the face as well as the eyelids, medial canthus, and lacrimal drainage system. Split-thickness skin grafts are useful in repairing these large defects and can be combined with other eyelid procedures such as the Hughes operation for lower-eyelid reconstruction.