Figure 1: A: Preoperatively, there was extensive upper and lower eyelid edema. B,C: MRI demonstrated marked periorbital involvement and edema. D,E: Intraoperatively, there was significant ischemia and edema of orbicularis muscle with removal of exudative material with a curette. F: In the immediately postoperative period with a drain in place, the patient had decreased edema and pain. G: Postoperative week 1, the patient continued to have reduction in erythema and edema. H: Several months later, the patient had made a full recovery without the need for reconstruction.