Surgical Planning for Resection and Reconstruction of Facial Cutaneous Malignancies

Skin cancer can be categorized into cutaneous melanoma and nonmelanoma skin cancer (NMSC). The latter includes such histologies as Merkel cell carcinoma (MCC), basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). Of these, BCC and SCC are the most common skin cancers of the head and neck while malignant melanoma is the most aggressive. Sunscreen protection and early evaluation of suspicious areas remain the first line of defense against all skin cancers. When prevention fails, the gold standard of skin cancer management involves a multidisciplinary approach which takes into account tumor location, stage and biology of disease, and availability of resources. Proper diagnosis, staging, and treatment planning must all be addressed prior to initiating interventions. When surgery is indicated, facial reconstruction is a key aspect of the overall treatment plan and requires informed forethought as well as experience and skill. Here, we present an overview of surgical reconstruction recommendations and considerations for the subsites involved in head and neck skin cancer.