Volume 14, Issue 4 (9-2026)
J Surg Trauma 2026, 14(4): 228-235 |
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Ethics code: IR.BUMS.REC.1404.333
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Sajadinejad B S, Mikaeeli M, Hemmati E. The Bilobed Rotation-Advancement Flap for Aesthetic Reconstruction of a Facial Defect After Excision of Giant Basal Cell Carcinoma: A Long-Term Follow-Up Case Report. J Surg Trauma 2026; 14 (4) :228-235
URL: http://jsurgery.bums.ac.ir/article-1-553-en.html
URL: http://jsurgery.bums.ac.ir/article-1-553-en.html
Department of Surgical Technology, School of Allied Medicine, Birjand University of Medical Sciences, Birjand, Iran.
Abstract: (523 Views)
Abstract
Giant basal cell carcinoma (GBCC) of the face is a rare condition that requires both proper oncologic control and acceptable aesthetic outcomes, which is a significant challenge due to the complex reconstructive demands of the post-excision defect.A male patient in his late 60s presented with an ulcerated GBCC measuring 4.5 × 6 cm involving the right cheek. The diagnosis was confirmed preoperatively by punch biopsy, and surgical management was planned to obtain complete excision while addressing the anticipated aesthetic and functional sequelae of a large facial defect. Wide local excision was performed with a 1-cm margin, after which immediate reconstruction was conducted using a regional bilobed rotation-advancement flap. The flap was designed to mobilize adjacent hair-bearing cervical skin to maximize tissue compatibility and restore the natural appearance of the involved facial subunit. Histopathologic examination confirmed pigmented GBCC with clear margins and no perineural or lymphovascular invasion. Postoperatively, facial nerve function was maintained, healing was uneventful, and long-term follow-up indicated stable reconstruction without any evidence of recurrence.This case highlights the bilobed rotation-advancement flap as an advantageous technique for reconstruction of selected sizable defects after excision of GBCC. The favorable long-term outcome indicates that, when properly planned, this technique can accomplish functional preservation, oncologic safety, and aesthetically acceptable restoration without the need for more extensive reconstructive procedures.
Giant basal cell carcinoma (GBCC) of the face is a rare condition that requires both proper oncologic control and acceptable aesthetic outcomes, which is a significant challenge due to the complex reconstructive demands of the post-excision defect.A male patient in his late 60s presented with an ulcerated GBCC measuring 4.5 × 6 cm involving the right cheek. The diagnosis was confirmed preoperatively by punch biopsy, and surgical management was planned to obtain complete excision while addressing the anticipated aesthetic and functional sequelae of a large facial defect. Wide local excision was performed with a 1-cm margin, after which immediate reconstruction was conducted using a regional bilobed rotation-advancement flap. The flap was designed to mobilize adjacent hair-bearing cervical skin to maximize tissue compatibility and restore the natural appearance of the involved facial subunit. Histopathologic examination confirmed pigmented GBCC with clear margins and no perineural or lymphovascular invasion. Postoperatively, facial nerve function was maintained, healing was uneventful, and long-term follow-up indicated stable reconstruction without any evidence of recurrence.This case highlights the bilobed rotation-advancement flap as an advantageous technique for reconstruction of selected sizable defects after excision of GBCC. The favorable long-term outcome indicates that, when properly planned, this technique can accomplish functional preservation, oncologic safety, and aesthetically acceptable restoration without the need for more extensive reconstructive procedures.
Type of Study: Case Report |
Subject:
Otolaryngology_ENT
Received: 2026/04/25 | Accepted: 2026/07/1 | ePublished ahead of print: 2026/07/21 | Published: 2026/09/1
Received: 2026/04/25 | Accepted: 2026/07/1 | ePublished ahead of print: 2026/07/21 | Published: 2026/09/1
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