Aesthetic Unit-Based Reconstruction of Facial Defects with Local Flaps after Surgical Excision of Basal Cell Carcinoma

Abstract

Background: Basal cell carcinoma (BCC) represents themost common type of facial skin cancer in Middle East andEgypt. It rarely metastasizes, but because of its locally destructivenature, it can cause high morbidity. Reconstructionby local flap after surgical excision depends on the size ofthe defect and the affected facial aesthetic unit.Aim: To reveal the prevalence of facial BCC, relation ofits site to facial aesthetic units and type of local flaps usedfor reconstruction per units.Patients and Methods: A retrospective study was conductedon 80 patients with facial BCC that admitted to the outpatientclinic, Plastic Surgery Department, Qena University Hospitalfrom June 2018 to May 2020 (2 years duration). Only earlystageand primary tumors were included. Statistical analysis:Data was analyzed using the Statistical Package for SocialSciences (SPSS) version 24. A p-value significant.Results: 80 patients with facial basal cell carcinoma (BCC)were collected from medical records. 45 (56.25%) patientswere males and 35 (43.75%) patients were females (M:F =1.3:1). Ages ranged from 52-78 years old (SD = 65±13).Nodular subtype was the most common clinical type of BCCand presented in 45 (56.25%) patients. Nasal unit was themost common site in 18 (22.5%) patients. The most randomflap applied was the rhomboid (Limberg) flap in 15 cases.The most axial flap used was the nasolabial flap in 9 cases.Complications (6 cases, 7.5%) included: Wound dehiscencein 3 cases, infection in 2 cases and skin slough in 1 case. TheSCAR scale score result ranged from 0-2 score.Conclusion: Facial defects reconstruction after surgeryfor basal cell carcinoma is a complex endeavor that requirescareful consideration. There are many different local flapsavailable depending on the particular facial subunit thatrequires reconstruction. Careful recognition of the principlesof the facial subunits will equip the surgeon to achieve thebest possible functional and aesthetic outcomes.