Modified H-plasty in large basal cell carcinoma defect reconstruction on the forehead

Basal cell carcinoma (BCC) is the most common malignancy worldwide. Surgical removal is considered the gold standard treatment. However, large defects following excisional surgery can pose a significant challenge for reconstruction, especially in cases where primary closure is not possible. In these cases, skin flaps may be used. Most traditional skin flaps are limited by design to take advantage of only one region of relative skin excess. This paper reports a case of a large forehead defect following BCC excision that was successfully reconstructed by a modified Hplasty involving a U-plasty and rotation-advancement flap. Maintenance of aesthetics without impaired function is the aim of closure defects with combined flaps.