Mohs micrographic surgery on the eyelid is one of the most precise applications of the technique. The eyelid is a thin, functionally critical structure with delicate margins, where preserving healthy tissue and protecting eye function are paramount.
Miss Rakhee Nayar performs Mohs surgery and reconstruction of the eyelid as a single consultant procedure. Dual training in Mohs and plastic surgery allows tumour removal with maximum cure rate, followed immediately by reconstruction designed to preserve eyelid function and natural appearance.
Why Mohs surgery on the eyelid
- Highest cure rates for basal cell and squamous cell carcinoma of the eyelid.
- Tissue-sparing technique preserves eyelid margin, lashes and underlying structures wherever possible.
- Margins confirmed clear before reconstruction begins.
- Single-day procedure under local anaesthetic in most cases.
Reconstruction after eyelid Mohs
Reconstruction is tailored to defect size and location, ranging from primary closure and skin grafts for smaller defects to multi-layered eyelid reconstruction (e.g. Tenzel flap, Cutler-Beard flap, Hughes procedure) for larger or full-thickness defects. Miss Nayar discusses all suitable options at consultation.
Is Mohs surgery safe so close to the eye?
Yes, and that is one of the main reasons it is recommended here. The eye itself is protected with a shield while the surgeon works, and the technique removes the least possible tissue, which matters on an eyelid where every millimetre affects how the lid closes and protects the eye. Basal cell carcinoma on the lower lid is the most common eyelid skin cancer, and it is exactly the kind of tumour Mohs handles well.
Will my vision be affected?
The surgery does not involve the eye itself. Swelling and bruising can partly close the eye for a few days, which looks worse than it feels and settles quickly. If the eye is padded after surgery you must not drive that day, so arrange a lift home.
What happens on the day?
The eyelid is numbed with local anaesthetic and you stay awake throughout. Each layer removed is examined under the microscope while you wait, and for most patients the repair is done in the same visit once the margins are clear. Some larger repairs are staged: the Hughes procedure, used for bigger lower-lid defects, is done in two operations a few weeks apart and involves the eye being closed between them. If a staged repair is likely, Miss Nayar will explain exactly what each stage involves before you decide anything.
Recovery after eyelid surgery
Bruising around the eye often looks dramatic in the first week and then fades quickly. Cold compresses help in the first day or two, stitches near the eye usually come out within a week, and you should avoid rubbing the area or wearing eye make-up until the wound has healed. Most people are comfortable in public within a fortnight.
Book a consultation
If you are weighing up treatment for a skin cancer on or near the eyelid, a consultation covers the diagnosis, the operation and how the repair would look. Consultations are usually available within days, not weeks. Bring your referral letter or biopsy result if you have one.