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Oculoplastic skin cancer surgery · UK

Eyelid skin cancer - protect the eye, restore the lid.

Margin-controlled excision followed by oculoplastic reconstruction for eyelid BCC, SCC and sebaceous carcinoma. A Mohs surgeon and an oculoplastic surgeon working together - because a normal-looking eyelid that will not close is not a success.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why patients choose us

  • 01

    A Mohs surgeon and an oculoplastic surgeon, together

    Two consultants, one operating list. Tumour cleared, lid reconstructed - no handovers between hospitals.

  • 02

    Function first, cosmesis second

    An eyelid that looks the same but does not close is not a success. We plan closure, tear film and margin position before we plan the scar.

  • 03

    Independent, and free

    We are paid by no clinic, so the recommendation is impartial and costs you nothing.

Indicative pricing

What eyelid skin cancer surgery costs in the UK.

Indicative ranges across our vetted UK partners. Send the details and we quote firm figures across two or three options, with cover checked.

In short

Mohs + Tenzel flap reconstruction on a lower lid: £6,500–£10,500, home the same day.

Procedure Indicative range
Small eyelid excision + direct closure £2,500–£4,500
Mohs + Tenzel semicircular flap £6,500–£10,500
Mohs + Hughes tarsoconjunctival flap (stage 1) £7,500–£11,500
Hughes flap division (stage 2) £1,500–£2,800
Mohs + Cutler-Beard (upper lid, staged) £8,500–£14,000
Medial canthus reconstruction £4,500–£8,500
Consultation with oculoplastic surgeon £280–£450

Prices depend on tumour size, number of Mohs stages and reconstruction complexity. Two-stage Hughes and Cutler-Beard cases sit at the top of the range. We quote firm figures once we have seen photographs.

The problem

The tumour matters - but so does whether your eye will close afterwards.

Eyelid skin cancer surgery is where two specialties must meet - one to clear the tumour, one to restore the lid. Done separately, cosmesis and function suffer.

  • Get the tumour, keep the lid

    Under-excision at the lid margin recurs. Over-excision leaves you unable to close the eye. Mohs is designed for exactly this.

  • Not every eyelid tumour needs a Hughes flap

    Half the periocular BCCs we see close with a Tenzel or direct closure. The reconstruction fits the defect, not the surgeon's habit.

  • Function before form

    Lid closure, blink, tear drainage - all planned first. The scar is optimised around them.

The journey

From enquiry to recovery - what happens, in order.

One team from first message through the procedure, results and follow-up.

  1. 01

    Before

    Send photographs and biopsy

    Close-up and lid-elevation photographs, any biopsy result, and details of prior eye surgery or dry eye.

  2. 02

    Before

    Joint recommendation

    Within one working day: the excision plan (Mohs or standard), the reconstruction plan, and the two surgeons proposed.

  3. 03

    Before

    Ophthalmic and photographic assessment

    Vision, lid function, dry-eye status. Marked photographs with the drawn-out closure plan.

  4. 04

    On the day

    Mohs stages

    Local anaesthetic. 1–3 stages typically, 90 min–4 h. Waits between stages while frozen sections are read.

  5. 05

    On the day

    Oculoplastic reconstruction

    Direct closure, Tenzel flap, Hughes tarsoconjunctival flap, Cutler-Beard, or free grafts. Eye shielded overnight.

  6. 06

    After

    Wound care and stage-two if needed

    Lubricants, cool compresses, tape-shield at night. Hughes and Cutler-Beard flaps divided at 4–6 weeks.

  7. 07

    After

    Scar and function review

    Six-week and six-month review with photographs and lid-function assessment.

When it helps

When combined Mohs and oculoplastic surgery is the right choice.

The tumours and sites where margin control plus specialist reconstruction changes the outcome - and the few cases where standard excision alone is enough.

  • Lower-lid BCC

    The commonest eyelid skin cancer we see - margin-controlled excision with Tenzel or Hughes reconstruction.

  • Medial canthus BCC

    High recurrence risk with standard excision - Mohs is preferred, closure often with a glabellar or paramedian flap.

  • Upper-lid BCC

    Less common but demanding - Cutler-Beard flap for larger defects, direct closure for small.

  • Squamous cell carcinoma

    Higher risk of perineural spread - margins matter, and radiotherapy may follow.

  • Sebaceous carcinoma

    Rare, aggressive - often masquerades as chronic blepharitis or chalazion. Requires wide margins and mapping biopsies.

  • Recurrent tumour

    Best served by Mohs with combined reconstruction - cure rates fall sharply with repeat standard excision.

  • Full-thickness lid margin involvement

    Both anterior and posterior lamellae need reconstruction - layered flaps and grafts.

  • Red flag: rapid growth, ulceration, lymph node

    Fast-growing periocular lesion, ulceration or a palpable preauricular node warrants two-week-wait review.

Options

Reconstruction - matched to size, layer and lid.

What each flap and graft involves - from direct closure to Hughes and Cutler-Beard procedures - and when a staged approach makes sense.

  • Direct closure ± lateral cantholysis

    For defects under one-third of the lid - a small canthal release lets edges meet cleanly.

  • Tenzel semicircular flap

    Rotates lateral skin and orbicularis to fill defects of one-third to half the lid.

  • Hughes tarsoconjunctival flap

    Two-stage: upper-lid conjunctiva-tarsus advanced into a large lower-lid defect, divided at 4–6 weeks.

  • Cutler-Beard flap

    Two-stage full-thickness lower-lid flap into a large upper-lid defect. Reserved for defects the other techniques cannot cover.

  • Free tarsal or hard-palate mucosal graft

    Posterior lamella replacement combined with an anterior skin flap.

  • Glabellar or paramedian forehead flap

    For medial canthal defects - brings skin from between the eyebrows.

  • Full-thickness skin graft (upper-lid donor)

    Anterior lamella replacement using contralateral upper-lid skin - excellent colour match.

  • Healing by secondary intention (selected)

    Small medial canthal defects sometimes give excellent scars with granulation alone.

Our vetted UK network

A small panel of consultants, we picked them.

Consultants across London and the major UK cities. Introductions are made privately, once we understand your case.

Selection criteria

How we choose every clinician in our network.

  • Fellowship-trained oculoplastic surgeons on the specialist register

  • BSDS-listed Mohs surgeons operating on the same list

  • Ophthalmology-grade theatre with microscope and eye-shield facilities

  • Formal photographic follow-up and audited lid function outcomes

Safety and recovery

What to expect afterwards - honestly.

Eyelid work has a strong safety record. What matters is preserving lid closure and tear drainage, and keeping the eye protected during any staged reconstruction.

  • Eye protection is central

    Corneal exposure is the main safety concern - lubricants, taping and shields between stages of any two-stage flap.

  • Ectropion and lid retraction

    Under-corrected lower-lid closure can retract downwards - corrected with tarsal strip or additional graft.

  • Ptosis after upper-lid work

    A Cutler-Beard flap or over-tight closure can drop the lid; usually settles or corrected with revision.

  • Tear drainage

    Medial canthal work can disturb the puncta and lacrimal canaliculi - silicone intubation used when needed.

  • Bleeding and haematoma

    Meticulous haemostasis; orbital haematoma is rare but treated urgently.

  • Infection

    Under 2%; postoperative antibiotic ointment is routine.

  • Recurrence risk

    After Mohs at the eyelid, five-year cure rate is around 99% for primary BCC and 94% for recurrent BCC.

  • Two-stage flap discomfort

    With a Hughes flap the eye is closed for 4–6 weeks - patients accept it for the reconstructive result.

  • Red flags after surgery

    Sudden vision change, severe eye pain, bulging or a growing haematoma need immediate contact - not a routine call.

Reading your notes

Your notes in four parts. Read the last one first.

The letter you receive from the consultant keeps to the same shape.

  1. 01 Tumour

    Type, site and margin

    Histology, lid and canthal involvement, Mohs stage count and confirmation of clear margins.

  2. 02 Reconstruction

    Flap or graft, layers

    Which anterior and posterior lamella techniques were used, donor sites, and any staged plan.

  3. 03 Function

    Closure, blink, tear drainage

    Documented lid closure at end of case, corneal protection plan, and any planned revision.

  4. 04 Impression

    Follow-up and long-term surveillance

    Read this first: dressing, drops, when to return, timing of any second-stage division, and skin surveillance advice.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Eyelid skin cancer surgery is usually covered under skin cancer benefit. Combined Mohs and oculoplastic reconstruction typically require pre-authorisation. We handle both.

Frequently asked

Everything we get asked about eyelid skin cancer surgery.

Quick answers on Mohs vs standard excision, Hughes flaps, lid function, cost and cure rates.

  • Will I be able to see and close my eye afterwards?

    After single-stage reconstructions (direct closure, Tenzel, medial canthal work) the eye opens the same day and closure returns quickly. Two-stage Hughes and Cutler-Beard flaps deliberately close the eye for 4–6 weeks between stages - patients accept it because the reconstructive result is much better than the alternatives.

  • Do I need Mohs, or is standard excision enough?

    Mohs is preferred for most eyelid tumours because it preserves tissue and gives higher cure rates on this cosmetically and functionally sensitive area. Small, well-defined BCCs away from the lid margin can be safely dealt with by standard excision with margin control.

  • What is a Hughes procedure?

    A two-stage reconstruction for large lower-lid defects. In stage 1, a tarsoconjunctival flap is advanced from the upper lid into the defect and an anterior skin flap covers it. In stage 2 (4–6 weeks later, under local anaesthetic), the flap is divided and the lids separated. Function and cosmesis are excellent.

  • Will the eyelid look and work the same?

    With good technique, cosmesis is excellent and function returns to normal in the majority. Some patients need a small revision - a tarsal strip for lower-lid laxity, or a graft for lid retraction - which we discuss in advance.

  • How much does eyelid skin cancer surgery cost privately in the UK?

    Roughly £2,500–£4,500 for small excisions with direct closure, £6,500–£10,500 for Mohs plus Tenzel flap, £7,500–£11,500 for Mohs plus Hughes (stage 1) with £1,500–£2,800 for stage 2, and £8,500–£14,000 for staged Cutler-Beard. Medial canthal reconstruction sits between £4,500 and £8,500.

  • What are the cure rates?

    After Mohs at the eyelid the five-year cure rate for primary BCC is around 99% and for recurrent BCC around 94%. SCC and sebaceous carcinoma have distinct pathways with additional oncology surveillance.

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