Combined Facial Reconstruction for Basal Cell Carcinoma Involving the Left Nasal Ala and Lower Eyelid: Case Presentation and Surgical Approach

This article presents the case of a 72-year-old female patient admitted for surgical treatment of a neglected basal cell carcinoma (BCC) involving the left nasal ala, lower eyelid, and left cheek, with an estimated evolution time of approximately two years. The diagnosis was established through dermatological evaluation, including dermatoscopy and confirmed by biopsy. Given the tumor’s extent and anatomical location, a comprehensive surgical approach was adopted. Complete excision of the tumor was performed with oncological safety margins, which were subsequently confirmed by histopathological examination. The resulting complex facial defect required immediate reconstruction to restore both functional and aesthetic aspects of the midface region. Reconstruction involved the use of multiple locoregional axial flaps, tailored to the specific tissue requirements and anatomical subunits affected. This technique allowed for optimal tissue coverage and contour restoration while minimizing donor site morbidity. The postoperative course was uneventful, with favorable healing and satisfactory functional and cosmetic outcomes. This case highlights the importance of early diagnosis and multidisciplinary management in advanced BCC cases, and demonstrates the effectiveness of combined facial flaps reconstruction in addressing complex facial defects following oncologic resection.