Tips to Avoid Webbing in the Medial Canthus

The presentation discusses techniques to avoid webbing in the medial canthus region during surgical closure of small defects. The speaker emphasizes that even minor defects can cause distortion and webbing, especially upon eyebrow movement. Attention is drawn to two case examples; in one, a patient opted for granulation, resulting in unfavorable distortion, and in another, a small scar led to webbing when the patient's expression changed. Key recommendations include checking for distortion during eyebrow elevation and maintaining proper flap tension during suturing. The speaker prefers transposition flaps, often using cheek skin as it better matches the texture of the medial canthus compared to nasal skin. It's crucial to place secondary defects in alignment with resting skin tension lines for aesthetic integration. Success is illustrated with cases showing no webbing four months post-surgery, highlighting the importance of careful flap design and placement. In instances where cheek skin is not an option, nasal skin may be used, but considerations regarding potential ectropion are necessary. The presentation concludes by reaffirming the importance of meticulous technique in achieving optimal closure outcomes.