Local flaps in facial skin cancer reconstruction: functional and aesthetic outcomes

Introduction. The most common malignant facial skin tumors are basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. Surgical excision remains the gold standard of treatment, followed by reconstruction of the resulting defect. The aims of this study were to present reconstructive options for facial defects following excision of malignant skin tumors and to evaluate functional and aesthetic outcomes of local flap reconstruction. Methods. This retrospective case series included 80 patients surgically treated at Varis Clinic in Belgrade and at the Department of Plastic and Reconstructive Surgery, University Hospital in Foča, from January 2021 to October 2025. Patients were analyzed with respect to tumor type, defect size and localization, sex, age, and postoperative complications. Reconstruction was performed using local flaps. Results. Facial defects resulted from excision of BCC in 51 patients, SCC in 24 patients, and melanoma in five patients. Complete flap survival was achieved in all cases (100%). Postoperative infection with marginal flap necrosis occurred in three patients (3.75%) and resolved after conservative treatment. Functional and aesthetic outcomes were satisfactory in all patients. Conclusion. Local flaps represent a reliable reconstructive method for small to large facial defects. Proper surgical planning, anatomical knowledge, and meticulous technique are essential for achieving optimal functional and aesthetic outcomes.