Reconstruction of Defects Following Excision of Basal Cell Carcinoma of Face: A Subunit-based Algorithm

Area of Science:

• Plastic Surgery
• Dermatology
• Oncology

Background:

• Basal cell carcinoma (BCC) is a common skin cancer requiring surgical excision.
• Reconstruction of facial defects after BCC removal is crucial for aesthetic and functional outcomes.
• Optimal reconstruction strategies for facial BCC excisions remain a focus of research.

Purpose of the Study:

• To review common principles for optimal reconstruction of facial defects after basal cell carcinoma excision.
• To develop a reconstruction algorithm based on a review of hospital records and literature search.
• To identify key factors influencing the choice of reconstructive techniques for facial BCC.

Main Methods:

• Retrospective review of 32 patients undergoing facial BCC excision and reconstruction.
• Comprehensive literature search of Embase, Medline, and Cochrane databases (last two decades).
• Development of a reconstruction algorithm based on identified principles and findings.

Main Results:

• A reconstruction algorithm was designed based on analysis of 32 patient cases and 218 reviewed journal articles.
• Key principles include understanding general reconstruction, facial aesthetics (subunit principle), flap anatomy, and surgeon experience.
• Complex defects may necessitate innovative solutions, multidisciplinary approaches, and advanced techniques like perforator flaps or supermicrosurgery.

Conclusions:

• Multiple reconstructive options exist for facial BCC defects, often manageable with an algorithmic approach.
• A thorough understanding of reconstructive principles and techniques is essential for successful outcomes.
• Further prospective studies are needed to compare reconstructive options and determine the most suitable approaches for specific defects.