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IMCAS China 2025
Program

Surgery - Difficult cases, how to manage

Room: Room 4
Date: Sunday 13 July 2025 at 15:00 to 16:30
Format: CLINICAL CASE STUDY > study of unusual or difficult patient cases to assess various treatment plans and discuss patient care

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
15:00	Dr Anca BORDIANU	Function and Aesthetics in Harmony: Reconstructive Approaches After Cephalic Non-Melanoma Skin Cancer Excision	View	147492
15:12	Dr Zoya EVSYUKOVA	Intraoperative use of recombinant angiogenin to improve the results of plastic surgery	View	147493
15:24	Dr Sebastian NISCHWITZ	Facial reconstruction after melanoma - dealing with a determined patient		147494
15:36	Prof Jed BOUGUILA	Endoscopic resection of benign frontal tumors: Technical note	View	147495
15:48	Dr Moez BELDI	Scalp reimplantation one case report		147496
16:00	Prof Kaiyang LV	The core concepts and techniques for the perfect repair of linear scars		147497
16:12		Discussion and Q&A		147499

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Dr Anca BORDIANU

Plastic Surgeon

Romania

Other author(s) :

Function and Aesthetics in Harmony: Reconstructive Approaches After Cephalic Non-Melanoma Skin Cancer Excision

Objectives: The primary objective of this study is to assess the effectiveness, safety, and aesthetic outcomes of different reconstructive surgical techniques employed after the excision of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in the cephalic region. Specifically, the study aims to evaluate the capacity of each technique, ranging from direct closure and local flaps to skin grafting, to restore both form and function in a region that is highly visible and functionally complex, focusing on both functional restoration and aesthetic results.

Introduction: Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most prevalent non-melanoma skin cancers, commonly affecting the head and neck region. While surgical excision remains the primary treatment modality, it often results in tissue defects that present considerable reconstructive challenges. Achieving a balance between function and aesthetics is critical in facial reconstruction, particularly due to the visibility and complexity of the cephalic region.

Materials / method: This retrospective study was conducted at the Plastic and Reconstructive Microsurgery Department of Bagdasar-Arseni Clinical Hospital in Bucharest. It included 372 patients treated over a five-year period. All patients underwent surgical excision of either BCC or SCC in the cephalic region, followed by reconstruction using techniques such as direct closure and a variety of local flaps, adapted to defect characteristics and individual patient needs. Skin grafting was reserved for carefully selected cases where flap coverage was not feasible.

Results: Local flap reconstruction was the most used technique and provided excellent outcomes, particularly in terms of contour and color match. Even in complex cases, local flaps yielded high levels of functional and aesthetic satisfaction.
Complication rates across all reconstructive methods were low. Most patients reported high satisfaction with the aesthetic results, and functional restoration was successfully achieved in nearly all cases.

Conclusion: Reconstruction after excision of cephalic BCC and SCC requires individualized planning and a defect-oriented approach. Local flap techniques proved to be highly versatile and effective, offering superior aesthetic integration and functional outcomes. This study reinforces the role of tailored reconstructive strategies in achieving harmony between form and function in oncologic facial surgery.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Zoya EVSYUKOVA

Facial Plastic Surgeon

Russia

Other author(s) :

Intraoperative use of recombinant angiogenin to improve the results of plastic surgery

Objectives: acceleration and qualitative improvement of skin flap regeneration after large dissections, prevention of ischemic complications, acceleration of edema relief and improvement of clinical results after facial plastic surgery by using recombinant angiogenin (RA)

Introduction: the high demands on the appearance of a modern person are reflected in the requirements for the work of plastic surgeons: it is not enough to perform an effective SMAS facelift, it is necessary to avoid long rehabilitation as much as possible, and make the marks from the sutures invisible. To this end, surgeons are constantly improving surgical techniques, and cosmetologists use modern regenerating agents,but still the risk of complications in the form of necrosis of skin flaps, formation of pathological scars and persistent edema are common phenomena that can spoil the result of the operation

Materials / method: In order to prevent the above-described phenomena and complications, I use recombinant angiogenin (RA) - a vascular growth factor obtained by a valuable engineering method, which 4 hours after its injection triggers the sprouting of new vessels, which is manifested by increased microcirculation, accelerated wound healing, growth of new lymphatic vessels and, as a result, rapid relief of edema. The first procedure of RA injection is performed during surgery, then every 24 hours for 4 days (during changing the dressing) and after 1 time per week in first 2 months

Results: RA has shown its effectiveness in a large number of surgical patients, even in those who had a high risk of skin necrosis in the area of aggressive dissection during classical High SMAS lifting. In patients with a tired aging morphotype, edema was completely resolved already in the first month after surgery, which is not typical for patients in this group without the use of RA. It is also worth noting the appearance of the scars: there were practically no traces visible after 4-5 weeks.

Conclusion: RA is a highly effective tool of regenerative medicine, which not only prevents vascular complications of extensive surgeries on the face and body, but also helps to obtain better results, which is due to the improvement of the skin condition, relief of the manifestations of many dermatoses and compaction of the dermis due to the stimulating effect of RA on fibroblasts.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Sebastian NISCHWITZ

Plastic Surgeon

Austria

Other author(s) :

Facial reconstruction after melanoma - dealing with a determined patient

Prof Jed BOUGUILA

Facial Plastic Surgeon

Tunisia

Other author(s) : Maha Mejbri

Endoscopic resection of benign frontal tumors: Technical note

Objectives: We describe a method of endoscopic excision of begnin forehead tumors, via two minimal incisions behind the hairline.

Introduction: Benign frontal tumors cause aesthetic disfigurement and occasional pain. The direct approach to these lesions creates a visible scar on the forehead and the coronal approach, sometimes used, can have as a scar ransom an unsightly alopecic area.

Materials / method: Operative technique: We describe a method of endoscopic excision of these forehead tumors, via two minimal incisions behind the hairline. The dissection plane is subperiosteal. Nerve and vascular injuries can be easily avoided using endoscopy.

Results: This technique was used in 25 patients between 2018 and 2024. The average age of our patients was 28 years (17 to 58 years). The lesions were: lipomas (14 cases), osteomas (8 cases) and cysts (3 cases). The average diameter of these lesions was 2.5 cm (1 to 4.5 cm). The average duration of the procedure was 50 min (40 to 90 min). No scar was visible on the postoperative frontal photos with an average follow-up of 8 months.

Conclusion: Aesthetic considerations are important characteristics of the craniomaxillofacial region especially for patients who do not accept the risk of a visible frontal scar. Endoscopic resection of benign tumors of the forehead can be useful by replacing the direct approach, responsible for a visible scar in young patients and the coronal approach whose postoperative consequences are heavier.
Endoscopy can be considered as an alternative means in the repertoire of maxillofacial surgeons and plastic surgeons.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Moez BELDI

Plastic Surgeon

Switzerland

Other author(s) :

Scalp reimplantation one case report

Prof Kaiyang LV

Plastic Surgeon

China

Other author(s) :

The core concepts and techniques for the perfect repair of linear scars

Discussion and Q&A

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IMCAS China 2025 Program

Surgery - Difficult cases, how to manage

Lectures of the session

Recommended sessions

IMCAS China 2025
Program