Editorial: Reconstructive and aesthetic surgery of the face: new frontiers in research and clinical applications

The face occupies a central place in human experience. It represents the primary medium of interpersonal communication and a fundamental component of individual identity, conveying emotions, intentions, and social cues. At the same time, it is one of the anatomical regions most frequently affected by cutaneous malignancies, often necessitating surgical excision followed by reconstruction 1 . The dual functional and symbolic value of the face makes any therapeutic intervention particularly delicate, as surgical treatment inevitably extends beyond the mere removal of disease and may significantly influence a patient's appearance, self-perception, and quality of life 2 . For these reasons, considerable efforts have been devoted over the years to refining reconstructive strategies capable of achieving optimal oncologic control while preserving form and function.Techniques have evolved from secondary intention healing and skin grafting to increasingly sophisticated local and microsurgical flaps, allowing tailored solutions based on defect size, depth, and anatomical subunit.A similar degree of attention has characterized the management of aesthetic concerns and agerelated changes of the face, including tissue ptosis, volume depletion of facial fat compartments, blepharochalasis, and alterations in skin quality. Advances in surgical expertise and technological innovation have led to highly specialized and progressively less invasive procedures, such as endoscopic approaches in forehead lifting, as well as a growing integration of regenerative techniques and energy-based devices. 3 The aim of this Research Topic is therefore to provide a comprehensive overview of current standards and emerging perspectives in facial treatment, encompassing reconstructive and aesthetic surgery alongside regenerative medicine and minimally invasive or non-invasive therapies.The collection brings together ten contributions addressing these diverse yet interconnected themes, offering updated insights and novel viewpoints in the management of facial pathologies and aesthetic subunits.In the work of Chen et al., for example, the use of CO2 lasers was analyzed in comparison with standard surgical treatment for basal cell carcinoma: the use of this less invasive technique achieved comparable efficacy with reduced complication rates., while Brambullo et al. introduced a modification of the traditional forehead flap, known as the "dragonfly" technique. This variant enables the simultaneous reconstruction of both the internal and external nasal layers using a single vascular pedicle, thus allowing for total nasal restoration in a single stage.Other works emphasize the importance of evaluating outcomes beyond purely technical success. In conclusion, the contributions gathered within this Research Topic address several fundamental dimensions of facial surgery, spanning oncologic management, reconstructive strategies, aesthetic refinement, technical surgical considerations, and the psychological implications that inevitably accompany interventions in the cephalic region. Although often analyzed separately for methodological clarity, these domains are deeply interdependent in clinical practice. The treatment of facial conditions, whether driven by malignancy, trauma, congenital anomalies, or elective aesthetic indications, rarely allows for a compartmentalized approach, as each intervention carries functional, morphological, and emotional consequences. Across all included works, a recurring message emerges: successful facial treatment requires a careful balance between oncologic radicality, reconstructive foresight, aesthetic harmony, and psychosocial awareness. The face is not merely an anatomical district but the core of individual identity and social interaction, and this complexity must guide every therapeutic decision.Nevertheless, several challenges remain. The need for standardized and validated outcome measures that integrate functional, aesthetic, and psychological parameters is increasingly evident.Long-term prospective data are still limited for many minimally invasive and regenerative approaches. Moreover, the integration of predictive models and individualized risk assessment tools into routine practice represents an important future direction, particularly in rhinoplasty and reconstructive planning. Finally, strengthening multidisciplinary collaboration between surgeons, dermatologists, oncologists, and mental health professionals will be essential to ensure truly patientcentered care.

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Journal
Frontiers in Surgery
Published
2026-04-07
DOI
https://doi.org/10.3389/fsurg.2026.1752335
Primary Topic
Reconstructive Facial Surgery Techniques
Type
article
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Editorial: Reconstructive and aesthetic surgery of the face: new frontiers in research and clinical applications

Giovanni PAPA, Marcello Molle, Martin Iurilli, Roberto Grella et al.
Frontiers in Surgery
Reconstructive Facial Surgery Techniques
article

Editorial: Reconstructive and aesthetic surgery of the face: new frontiers in research and clinical applications

Giovanni PAPA, Marcello Molle, Martin Iurilli, Roberto Grella, Mario Faenza
article en

Abstract

The face occupies a central place in human experience. It represents the primary medium of interpersonal communication and a fundamental component of individual identity, conveying emotions, intentions, and social cues. At the same time, it is one of the anatomical regions most frequently affected by cutaneous malignancies, often necessitating surgical excision followed by reconstruction 1 . The dual functional and symbolic value of the face makes any therapeutic intervention particularly delicate, as surgical treatment inevitably extends beyond the mere removal of disease and may significantly influence a patient's appearance, self-perception, and quality of life 2 . For these reasons, considerable efforts have been devoted over the years to refining reconstructive strategies capable of achieving optimal oncologic control while preserving form and function.Techniques have evolved from secondary intention healing and skin grafting to increasingly sophisticated local and microsurgical flaps, allowing tailored solutions based on defect size, depth, and anatomical subunit.A similar degree of attention has characterized the management of aesthetic concerns and agerelated changes of the face, including tissue ptosis, volume depletion of facial fat compartments, blepharochalasis, and alterations in skin quality. Advances in surgical expertise and technological innovation have led to highly specialized and progressively less invasive procedures, such as endoscopic approaches in forehead lifting, as well as a growing integration of regenerative techniques and energy-based devices. 3 The aim of this Research Topic is therefore to provide a comprehensive overview of current standards and emerging perspectives in facial treatment, encompassing reconstructive and aesthetic surgery alongside regenerative medicine and minimally invasive or non-invasive therapies.The collection brings together ten contributions addressing these diverse yet interconnected themes, offering updated insights and novel viewpoints in the management of facial pathologies and aesthetic subunits.In the work of Chen et al., for example, the use of CO2 lasers was analyzed in comparison with standard surgical treatment for basal cell carcinoma: the use of this less invasive technique achieved comparable efficacy with reduced complication rates., while Brambullo et al. introduced a modification of the traditional forehead flap, known as the "dragonfly" technique. This variant enables the simultaneous reconstruction of both the internal and external nasal layers using a single vascular pedicle, thus allowing for total nasal restoration in a single stage.Other works emphasize the importance of evaluating outcomes beyond purely technical success. In conclusion, the contributions gathered within this Research Topic address several fundamental dimensions of facial surgery, spanning oncologic management, reconstructive strategies, aesthetic refinement, technical surgical considerations, and the psychological implications that inevitably accompany interventions in the cephalic region. Although often analyzed separately for methodological clarity, these domains are deeply interdependent in clinical practice. The treatment of facial conditions, whether driven by malignancy, trauma, congenital anomalies, or elective aesthetic indications, rarely allows for a compartmentalized approach, as each intervention carries functional, morphological, and emotional consequences. Across all included works, a recurring message emerges: successful facial treatment requires a careful balance between oncologic radicality, reconstructive foresight, aesthetic harmony, and psychosocial awareness. The face is not merely an anatomical district but the core of individual identity and social interaction, and this complexity must guide every therapeutic decision.Nevertheless, several challenges remain. The need for standardized and validated outcome measures that integrate functional, aesthetic, and psychological parameters is increasingly evident.Long-term prospective data are still limited for many minimally invasive and regenerative approaches. Moreover, the integration of predictive models and individualized risk assessment tools into routine practice represents an important future direction, particularly in rhinoplasty and reconstructive planning. Finally, strengthening multidisciplinary collaboration between surgeons, dermatologists, oncologists, and mental health professionals will be essential to ensure truly patientcentered care.

Frontiers in SurgeryVol. 13
University of Trieste (IT), University of Campania "Luigi Vanvitelli" (IT)
Industry, innovation and infrastructure
Openalex Percentile: Top 32%
Reconstructive Facial Surgery Techniques
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