This article presents a full-thickness lower eyelid margin repair performed following Mohs excision of an 8-mm basal cell carcinoma. The video demonstrates layered closure of the defect using vertical mattress sutures through the tarsus and orbicularis, followed by a running skin closure with plain gut. Special attention is given to maintaining lid architecture, minimizing corneal irritation, and preserving eyelid function. The case highlights decision-making in reconstructive planning and the utility of direct closure techniques when sufficient lower lid laxity is present.