Stable Upper Eyelid after 2 Successive Tarsoconjunctival Flaps.

A 70-year-old male with history of multiple cutaneous squamous cell carcinoma throughout the body presented with a left lower lid margin squamous cell carcinoma. The lesion was excised via Mohs surgery elsewhere, and the defect was reconstructed with a tarsoconjunctival flap (Hughes flap). The lesion recurred, and the patient had a second Mohs surgery for excision. For reconstruction, a second tarsoconjunctival flap spanning the entire horizontal distance of the upper lid was done. The remaining 2-3 mm of upper tarsus provided good support of the upper lid. Careful planning may allow for successive tarsoconjunctival flaps if needed in the future.