Alternatives to Flaps and Grafts for Management of Forehead Mohs Defects

Patients have varying goals for reconstruction after Mohs micrographic surgery, and the operative plan should reflect these goals. Forehead reconstruction with immediate flaps and grafts may not always align with these goals, and alternative methods should be considered. Evidence suggests that secondary intention healing, delayed or augmented skin grafting, skin substitutes, and delayed reconstruction with tissue expansion are acceptable alternatives to standard flaps and grafts. When possible, these options should be included in shared decision-making before reconstruction.