Optimizing Facial Reconstruction of Skin Cancer Defects With Combined Local Flaps

Facial skin cancer and the resulting surgical scars can significantly impact patient's quality of life. Reconstructive surgery following excision is often necessary to restore facial esthetics, with local flaps commonly used due to their favorable texture, color, and vascularity. Flaps from the same esthetic unit help minimize scarring; however, larger defects or those involving multiple anatomical units may require alternative approaches. This study evaluates the use of combined local flaps for reconstructing large facial defects or those involving multiple anatomical units after Mohs micrographic surgery, focusing on minimizing scarring and preserving facial contours. Four cases of basal cell carcinoma, each involving large defects ormultiple anatomical units, were reconstructed using combined local flaps. All cases showed successful esthetic outcomes, with well-preserved facial features and minimal scarring. In selected cases, reconstructing defects after skin cancer excision with multiple local flaps or advancements across subunits can lead to inconspicuous scars and satisfactory esthetic outcomes.