Facial reconstruction following basal cell carcinoma: repair using a paramedian forehead flap-a case report

Orson R. Juan; Manuel A. Baas; Tomiko I. Juan; Jonathan C. Barrientos; Jose L. Lozano; Jesus E. C. Villegas

doi:10.18203/2320-6012.ijrms20253186

Authors

Orson R. Juan Department of Surgery, Ignacio Garcia Tellez IMSS, Merida, Yucatan, Mexico
Manuel A. Baas Department of Surgery, Ignacio Garcia Tellez IMSS, Merida, Yucatan, Mexico
Tomiko I. Juan Department of Pediatrics, Centro Medico Nacional de Occidente IMSS, Merida, Yucatan, Mexico
Jonathan C. Barrientos Department of Surgery, Ignacio Garcia Tellez IMSS, Merida, Yucatan, Mexico
Jose L. Lozano Department of Surgery, Ignacio Garcia Tellez IMSS, Merida, Yucatan, Mexico
Jesus E. C. Villegas Departament of Intern Medicine, Hospital Mac Leon, Guanajuato, Mexico

DOI:

https://doi.org/10.18203/2320-6012.ijrms20253186

Keywords:

Basal cell carcinoma, Paramedian forehead flap, Case report, Full-thickness nasal defect, Nasal reconstruction

Abstract

Basal cell carcinoma (BCC) is the most common malignant cutaneous neoplasm, primarily affecting sun-exposed areas, with the nasal region being one of the most frequently involved sites. Here this report presents the case of a 68-year-old male presenting with an ulcerated lesion on the nasal tip, clinically consistent with nodular ulcerative BCC. A wide local excision was performed, and intraoperative frozen section analysis confirmed tumor-free margins. Reconstruction of the resulting full-thickness nasal defect was accomplished using a two-stage interpolated paramedian forehead flap. The postoperative course was uneventful, yielding an outcome that was both aesthetically satisfactory and functionally robust, with no evidence of recurrence during short-term follow-up. This case highlights the importance of meticulous oncologic resection and tailored reconstructive planning in managing complex nasal defects caused by skin cancer.

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