title: A Retrospective Review of Reconstructive Options and Outcomes of 202 Cases Large Facial Mohs Micrographic Surgical Defects, Based on the Aesthetic Unit Involved.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center Rotterdam, The Netherlands.
authors.forename: Anne C
authors.initials: AC
authors.lastname: van Leeuwen
authors.affiliation: Department of Dermatology and Venereology, Erasmus University Medical Center Rotterdam, The Netherlands.
authors.forename: Ayleen
authors.initials: A
authors.lastname: The
authors.affiliation: Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center Rotterdam, The Netherlands.
authors.forename: Sanne E
authors.initials: SE
authors.lastname: Moolenburgh
authors.affiliation: Department of Dermatology and Venereology, Erasmus University Medical Center Rotterdam, The Netherlands.
authors.forename: Ellen R M
authors.initials: ER
authors.lastname: de Haas
authors.affiliation: Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center Rotterdam, The Netherlands m.mureau@erasmusmc.nl.
authors.forename: Marc A M
authors.initials: MA
authors.lastname: Mureau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D005153:Facial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D015580:Mohs Surgery; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome
keywords: cancer; dermatology; surgery; wound