Background: Eyelid reconstruction is particularly challenging because of the delicate anatomy and its critical functional and aesthetic roles. Although various methods have been described for anterior and posterior lamellar repairs, no standardized approach has been established. We developed a single-stage technique integrating reconstruction of both lamellae. Methods: This retrospective case series included seven consecutive patients who underwent full-thickness eyelid reconstruction between 2012 and 2024. Patients were included if they had full-thickness defects requiring reconstruction of both lamellae, underwent reconstruction using a nasal septal chondromucosal graft combined with a large local flap, and had at least 12 months of follow-up. The posterior lamella was reconstructed using nasal septal chondromucosal grafts, and the anterior lamella using large local flaps. Donor sites were managed using various methods. Results: All patients (7/7) achieved complete graft survival without partial or total graft loss. All patients achieved complete eyelid closure without lagophthalmos, and no cases of ectropion, corneal complications, or graft failure were observed. Buccal mucosal grafting demonstrated the most favorable donor-site outcomes, with uneventful healing and no septal perforation or airway-related complications. Conclusions: This single-stage approach combining chondromucosal grafts and local flaps is a feasible and reproducible option for selected patients, providing reliable structural support and satisfactory functional outcomes.

Background/Objectives: Extramammary Paget’s disease (EMPD) of the scrotum, a rare intraepithelial adenocarcinoma, closely mimics benign dermatoses and is often diagnosed only after years of unsuccessful topical treatment. Because tumor cells extend beyond the visible border, wide excision often leaves large defects and positive margins. When disease reaches the perianal skin, clearance may cost anorectal function. Case: A 69-year-old male had been treated for presumed scrotal eczema for 9 years before punch biopsy established EMPD extending from the scrotum across the perineum to the medial thigh and anal verge. After wide excision with a 2-cm margin, frozen section showed intraepidermal Paget cells at the perianal margin; because clearance risked sphincter resection, further excision was withheld. The continuous defect was reconstructed with an 18 × 12 cm anterolateral thigh (ALT) island flap. The flap survived completely. Medical oncology recommended surveillance, with radiotherapy or systemic therapy reserved for progression. The site remained stable at 6 months; the patient was then lost to follow-up untreated. Conclusions: When a positive margin is accepted to preserve function, tissue that can be re-elevated, tolerates irradiation, and leaves residual disease accessible to inspection is a reasonable choice, although this remains untested here and the oncologic outcome is unknown.