Tenzel semicircular flap

The Tenzel semicircular flap was first described by Dr. Richard Tenzel in 1975. The semicircular flap is useful for reconstruction of central lower eyelid defects. The Reverse Tenzel semicircular flap is performed for central upper eyelid defects. While canthotomy and cantholysis alone may be used to reconstruct defects comprising up to 25 %, the addition of the semicircular flap is useful to reconstruct defects as large as two-thirds of the eyelid with the caveat that tarsus is present on both sides of the surgical defect. The semicircular flap is rotated and advanced into the defect allowing for adequate wound closure. The procedure also requires reconstruction of the lateral canthus to restore the canthal angle and the blink dynamic. This is accomplished through fixation of the flap to the periosteum of the lateral orbital rim.