Repair of a Large Vermilion Defect of the Lower Lip Following Micrographic Surgery

Reconstruction of surgical defects of the face following Mohs micrographic surgery (MMS) requires careful consideration of both functional and cosmetic outcomes. In this report, we present a complex case of biopsy-proven invasive Bowenoid squamous cell carcinoma with extensive lower lip involvement, resulting in a large musculomucosal defect after MMS. The defect was closed using a multilayered approach with local tissue advancement to reduce tension and eliminate the need for secondary donor sites. Long-term follow-up demonstrated excellent cosmetic and functional outcomes without evidence of recurrence.