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.
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