Related Experiment Video
Updated: Jul 26, 2026
Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Serial excision of a large facial skin cancer
1Department of Dermatology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, andDepartment of Dermatology, Mayo Clinic Jacksonville, Jacksonville, Florida, USA.
Background:
In the management of large facial neoplasms, the dermatologic surgeon must consider local factors affecting the success of closures.
Objective:
Large facial neoplasms can be removed serially with Mohs micrographic surgery. Serial excision facilitates recruitment of adjacent normal skin for replacement of lesional skin, minimizing the risks of necrosis.
Methods:
A large morpheaform basal cell carcinoma was excised serially. The initial defect was closed with an O to L advancement flap. The final excision and repair 2 months later consisted of a combination of primary closure with marsupialization and pursestring closure. A full-thickness skin graft was used to close the final defect.
Results:
The patient had optimal cosmesis at 2-year follow-up.
Conclusion:
Large facial neoplasms can be excised serially. This technique, performed in the setting of Mohs micrographic surgery, takes advantage of "mechanical and biologic creep," resulting in excellent cosmesis and function.
Insights
Serial excision with Mohs micrographic surgery effectively treats large facial neoplasms. This approach utilizes adjacent skin for reconstruction, ensuring optimal cosmetic outcomes and minimizing necrosis risks.
Area of Science:
- Dermatologic Surgery
- Oncology
- Reconstructive Surgery
Background:
- Managing large facial neoplasms requires careful consideration of local factors influencing closure success.
- Mohs micrographic surgery offers a method for serial excision of extensive facial tumors.
- Serial excision aims to utilize adjacent healthy skin for reconstruction, reducing necrosis risk.
Observation:
- A case study involved serial excision of a large morpheaform basal cell carcinoma.
- Initial defect closure utilized an O to L advancement flap.
- Subsequent repair involved primary closure, marsupialization, pursestring closure, and a full-thickness skin graft.
Findings:
- The patient achieved optimal cosmetic results at a 2-year follow-up.
- Serial excision, combined with Mohs micrographic surgery, leverages "mechanical and biologic creep."
- This technique resulted in excellent cosmesis and function for the patient.
Implications:
- Serial excision is a viable technique for managing large facial neoplasms.
- The method, when integrated with Mohs micrographic surgery, yields superior cosmetic and functional results.
- This approach minimizes complications and enhances patient outcomes in complex facial tumor removal.
Related Concept Videos
01:19Clinical Applications of Epidermal Stem Cells
01:30Skin Cancer
Basal Cell Carcinoma (BCC): BCC is the most common type of skin cancer, accounting for about 80% of cases. It typically develops in...