Facial Basal Cell Carcinoma: Clinical Profile, Surgical Management and Outcomes

Basal cell carcinoma (BCC) is the most common cutaneous malignancy worldwide. The face is the most frequent site and presents reconstructive and functional challenges after excision. This study describes the clinical profile, surgical strategies and reconstructive outcomes of facial BCC cases managed in a tertiary hospital in Bangladesh. Retrospective analysis of 62 consecutive patients with histologically confirmed facial BCC treated surgically between January 2021 and December 2024 at the Burn and Plastic Surgery Department, Mymensingh Medical College and Hospital. Demographic, clinical, operative and follow-up data were extracted from the institutional records. The primary outcomes were lesion distribution, reconstructive method, complications and need for re-excision. Sixty-two patients (mean age 54.3±13.7 years; male 54.8%) were included. Lesions were most commonly on the right side of the face (51.6%). Mean wound dimension was 17.06±10.43 cm². One-stage surgery was performed in 71.0% of patients; two-stage procedures in 29.0%. Re-excision was required in 3(4.8%) patients. The most used reconstructive options were split-thickness skin graft (STSG) (41.9%), full-thickness skin graft (FTSG) (11.3%) and local advancement flaps (12.9%). Major complications occurred in 4(6.5%) cases; most complications required revision. Mean postoperative stay was 3.9±2.48 days and mean follow-up was 9.7±2.96 weeks. Facial BCC in our series presented mainly in middle-aged adults and was most frequently managed by surgical excision with reconstruction using skin grafts and local flaps. Overall complication and re-excision rates were low. Surgical excision with appropriate reconstructive planning remains the cornerstone of facial BCC management.