Background: For optimal treatment of facial defects following Mohs micrographic surgery (MMS), the aesthetic unit principles should be applied. Often multiple staged procedures and revisions are necessary. Objective: To analyze the reconstructive options and outcomes for complex facial defects per aesthetic unit. Methods: Data of 202 patients, who underwent a facial reconstruction at the department of plastic and reconstructive surgery following MMS, were collected. Results: The central facial units were affected in more than 70%, with over 20% of the defects involving more than 1 unit. Nasal defects required the longest reconstruction time (3-staged forehead flap) and periocular defects the most revisional procedures. In more than 50%, additional operations (range, 1-5) were needed. In 12%, postoperative complications occurred. Conclusion: An overview for the reconstructive options of extensive facial skin cancer is presented. Proper treatment requires a structured multidisciplinary approach in order to achieve excellent tumour control and a satisfactory aesthetic and functional end result.

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Journal of Cutaneous Medicine and Surgery
Department of Plastic and Reconstructive Surgery

Van Leeuwen, A. C., The, A., Moolenburgh, S., de Haas, E., & Mureau, M. (2015). A retrospective review of reconstructive options and outcomes of 202 cases large facial Mohs micrographic surgical defects, based on the aesthetic unit involved. Journal of Cutaneous Medicine and Surgery (Vol. 19, pp. 580–587). doi:10.1177/1203475415586665