A Retrospective Review of Reconstructive Options and Outcomes of 202 Cases Large Facial Mohs Micrographic Surgical Defects, Based on the Aesthetic Unit Involved

Background: For optimal treatment of facial defects following Mohs micrographic surgery (MMS), the aesthetic unit principles should be applied. Often multiple staged procedures and revisions are necessary. Objective: To analyze the reconstructive options and outcomes for complex facial defects per aesthetic unit. Methods: Data of 202 patients, who underwent a facial reconstruction at the department of plastic and reconstructive surgery following MMS, were collected. Results: The central facial units were affected in more than 70%, with over 20% of the defects involving more than 1 unit. Nasal defects required the longest reconstruction time (3-staged forehead flap) and periocular defects the most revisional procedures. In more than 50%, additional operations (range, 1-5) were needed. In 12%, postoperative complications occurred. Conclusion: An overview for the reconstructive options of extensive facial skin cancer is presented. Proper treatment requires a structured multidisciplinary approach in order to achieve excellent tumour control and a satisfactory aesthetic and functional end result.