Combination of advancement and rotation flap for large defect closure of basal cell carcinoma on the cheek, lip and nose


Basal Cell Carcinoma (BCC) is a type of skin cancer, which is associated with UV radiation exposure. Modalities for treatment BCC such as Mohs surgery or delayed Mohs surgery remains the gold standard of current treatment. The choice of therapy is based on the type of histology, lesions, cost, size and location, the patient’s age, and the patient’s medical condition. We report a case of basal cell carcinoma located on the cheek and nose. The case of basal cell carcinoma located on the cheek and nose, and a closure procedure was carried out using a combination of forward and rotational movements, then evaluated during 6-month intervals and obtained good results.


  • Alcalay, J, Alkalay, R. (2008).Mohs Micrographic Surgery. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. New York: McGraw-Hill Education; p. 2950–6.
  • Dourmishev, L. A., Rusinova, D., & Botev, I. (2013). Clinical variants, stages, and management of basal cell carcinoma. Indian dermatology online journal, 4(1), 12.
  • Ducic, Y., & Burye, M. (2000). Nasolabial flap reconstruction of oral cavity defects: a report of 18 cases. Journal of oral and maxillofacial surgery, 58(10), 1104-1108.
  • Garcovich, S., Colloca, G., Sollena, P., Andrea, B., Balducci, L., Cho, W. C.,... & Peris, K. (2017). Skin cancer epidemics in the elderly as an emerging issue in geriatric oncology. Aging and disease, 8(5), 643.
  • Goldman, GD.(2005). Rotation flaps. Dermatologic Surgery. 31(8 Pt 2): 1006-13.
  • Greenstein, G., Greenstein, B., Cavallaro, J., Elian, N., & Tarnow, D. (2009). Flap advancement: practical techniques to attain tension‐free primary closure. Journal of periodontology, 80(1), 4-15.
  • Krishnan, R., Garman, M., Nunez‐Gussman, J., & Orengo, I. (2005). Advancement flaps: a basic theme with many variations. Dermatologic surgery, 31, 986-994.
  • Kruter, L., & Rohrer, T. (2015). Advancement flaps. Dermatologic Surgery, 41, S239-S246.
  • Momeni, A, Souza, KE. (2019).Local Skin Flaps. In Chang J, editors. Global Reconstructive Surgery. Elsevier Inc.; p. 86–99.
  • Penna, V., Stark, G. B., Eisenhardt, S. U., Bannasch, H., & Iblher, N. (2009). The aging lip: a comparative histological analysis of age-related changes in the upper lip complex. Plastic and reconstructive surgery, 124(2), 624-628.
  • Prendergast, PM.(2013). Anatomy of the face and neck. In Shiffman MA, Di Giuseppe A, editors. Cosmetic Surgery: Art and Techniques. Berlin Heidelberg: Springer; p. 29–45.
  • Raklyar, E, Zloty, DM.(2012). Use of a patient and observer scar assessment scale to evaluate the V-Y advancement flap for reconstruction of medial cheek defects. Dermatologic Surg. 38(12):1968–74.
  • Richard, M. J., Morris, C., Deen, B. F., Gray, L., & Woodward, J. A. (2009). Analysis of the anatomic changes of the aging facial skeleton using computer-assisted tomography. Ophthalmic Plastic & Reconstructive Surgery, 25(5), 382-386.
  • Taylor, G. I., Corlett, R. J., Dhar, S. C., & Ashton, M. W. (2011). The anatomical (angiosome) and clinical territories of cutaneous perforating arteries: development of the concept and designing safe flaps. Plastic and reconstructive surgery, 127(4), 1447-1459.
  • Wollina, U. (2015). Reconstruction of large facial defects after delayed Mohs surgery for skin cancer. Acta dermatovenerologica Croatica, 23(4), 265-265.


This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.