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ISSN 1405-0625 (Print)

2026, Number 2

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Cir Plast 2026; 36 (2)

Surgical geometry in the malar-preauricular region: combined local flaps for safe closure after resection of squamous cell carcinoma. Case report

Ruiz-Betanzos ÁJ, Lugo-Díaz JA, Alegria-Reyes A, Sánchez-Ríos C, Guzmán-Ballesteros SD, Gutiérrez-Quintanar A

Language: Spanish
References: 16
Page: 162-168
PDF size: 3913.07 Kb.


ABSTRACT

Cutaneous squamous cell carcinoma of the malar-preauricular region requires safe oncologic margins and a reconstruction that preserves function and aesthetics. The purpose of this study was to describe a safe oncologic-reconstructive strategy based on geometric planning and combined local flaps for immediate closure in a 91-year-old man with two lesions in the cheek and preauricular area. The biopsy confirmed moderately differentiated cutaneous squamous cell carcinoma. Immediate reconstruction used an inter-lesional transposition flap and a Limberg flap. A clinical and histopathological follow-up was performed at one, three, and six months. The report revealed margins were tumor-free. Initial viability was ~90%, improving to ~95% at 72 hours. Healing occurred without necrosis. There were no alterations in facial nerve function; the malar contour and preauricular sulcus were preserved. Functional and aesthetic outcomes at six months were satisfactory. Tension-free flap planning, combining inter-lesional transposition and Limberg flaps, allows safe closure of facial defects (malar/preauricular) following wide excision of cutaneous squamous cell carcinoma.


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