Figure 4.

(A) Preoperative photograph of an 88-year-old female with biopsy confirmed melanoma of the right medial canthus. The excision margins have been marked with a 5 mm border surrounding the lesion. The margins include the entire medial canthus, greater than 50% of the lower lid, 33–50% of the upper lid, and lacrimal systems of both upper and lower eyelids. Portions of the brow, nose, and cheek are also encompassed within the resection margins. (B) Intraoperative photograph of the resulting defect immediately following excision of the tumor detailed in (A). The depth of the resection was to bare sclera and continued medially on the surface of the medial canthal tendon to the lateral nasal wall. Dissection was continued superiorly and inferiorly to the included portions of the brow and cheek, respectively. All tissues anterior to periosteum were removed.