Patient-Centered Facial and Orofacial Reconstruction After Cutaneous Cancer Resection: Integrating Function, Aesthetics, and Quality of Life

Résumé fourni par la source

Facial and orofacial reconstruction following cutaneous oncologic resection represents a complex clinical challenge in which tumor control must be integrated with preservation of function, restoration of facial appearance, and maintenance of quality of life. This study analyzed contemporary reconstructive strategies used after facial skin cancer excision, with emphasis on the relationship between defect characteristics, anatomical location, surgical technique, functional recovery, aesthetic integration, postoperative complications, and patient-reported outcomes. A structured review was conducted under the Scientific Method framework, incorporating clinical guidelines, systematic reviews, observational studies, reconstructive case series, and investigations focused on patient-reported outcomes. The findings showed that reconstructive success depends primarily on individualized surgical planning rather than on the superiority of a single technique. Primary closure, skin grafts, local flaps, regional or staged flaps, and microvascular free-tissue transfer provide different advantages according to defect size, depth, tissue involvement, and functional requirements. Nasal reconstruction requires preservation of airway patency and structural support; periocular reconstruction prioritizes ocular protection and eyelid closure; and lip and perioral reconstruction requires maintenance of oral competence, speech, and feeding. The evidence also demonstrated that flap survival and wound healing alone are insufficient to define successful reconstruction. Aesthetic integration, complication burden, patient satisfaction, psychological well-being, and social reintegration must also be considered. Patient-reported outcome measures, including the FACE-Q Skin Cancer Module, strengthen the assessment of reconstructive effectiveness. Overall, the evidence supports a multidimensional and patient-centered approach in which oncologic safety, function, aesthetics, and quality of life are balanced to achieve comprehensive recovery after facial and orofacial cancer surgery.

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