Facial skin cancer reconstruction

Cancer clearance comes first

The diagnosis, location and risk features guide removal of the cancer. A biopsy or previous pathology report helps planning. The final wound can be larger or deeper than the visible lesion, so the repair sometimes needs to change at surgery.

Reconstruction may be immediate or staged while clearance is clarified. If further cancer remains at a margin, additional treatment may be required. Your treating team will explain the sequence and follow-up.

Assessment and reconstructive options

Assessment considers wound size and depth, nearby skin, previous scars or radiotherapy, facial function, general health, medicines and healing risks. Your priorities are part of the discussion.

A smaller wound may allow direct closure. A skin graft moves skin from a separate donor site; a local flap moves nearby tissue while preserving its blood supply. More complex defects can require staged flaps, structural support or multidisciplinary reconstruction. The simplest appropriate repair is not necessarily the same for two similar-looking wounds.

See skin grafts and local flaps for how these methods differ.

Protecting function and appearance

Scars are planned with facial contours and tension in mind, but cannot be made invisible. Around an eyelid, avoiding distortion and protecting the eye are important. Nasal reconstruction may need to consider breathing and support. Lip reconstruction considers mouth closure, movement and oral function.

Some repairs need more than one operation. Swelling and tissue thickness can change as healing progresses, and later revision may be considered for selected problems. Perfect symmetry or an exact match cannot be promised.

Anaesthesia, recovery and follow-up

Local anaesthesia may be suitable for smaller repairs. Sedation or general anaesthesia and hospital treatment may be appropriate for larger or more complex surgery. The planned repair and your health guide arrangements.

Dressings, wound cleaning, activity restrictions and suture removal depend on the repair. Swelling and bruising are expected to varying degrees. Protect the wound and follow any instructions about sleeping position, glasses, exercise or pressure on a graft or flap.

Review includes wound healing and pathology results. Continue skin checks and sun protection as advised by your treating doctors.

Scars, risks and when to seek help

Risks include bleeding, infection, delayed healing, wound separation, graft or flap loss, altered sensation, pain, contour or colour mismatch and further surgery. Scarring or tissue tension can affect a nearby eyelid, nostril or lip. Cancer recurrence remains possible despite treatment.

Contact the treating team promptly for increasing pain, redness, fever, persistent bleeding, new wound discolouration or other changes described in your postoperative instructions. New visual problems after surgery near the eye require urgent assessment.

Frequently asked questions

Related information