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Scientific Oral Presentations

Facial Plastic and Reconstructive Surgery

Session: Scientific Oral Presentations 3 - Facial Plastics and Reconstructive Surgery

Reconstructive Outcomes of Mohs Facial Defects Using Local and Locoregional Reconstruction Methods

Tuesday, October 14, 2025
11:24 AM - 11:30 AM EDT
Location: 137
Disclosure(s):
Alexa L. Lacy, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Mohs facial defects can be repaired with a variety of local and locoregional reconstruction methods. This study aims to compare the clinical outcomes of reconstructive methods used for small to large defects.

Methods: Retrospective review of adult patients who underwent repair of Mohs facial defects by otolaryngology and plastic surgery teams at Atrium Health Wake Forest Baptist from 2010 to 2020. Our preliminary analysis assessed outcomes across various reconstructive techniques.

Results: 122 patients included. Males: 83/122 (68%), females: 39/122 (32%). Reconstruction types: direct linear closure 10/122 (8%), skin grafts 13/122 (11%), local flaps 87/122 (71%), locoregional flaps 4/122 (3%), and multiple techniques 8/122 (7%). Reconstruction type correlated with defect size: direct linear closure was used for the smallest defects (2 cm), while locoregional flaps addressed the largest (5.9 cm; p< 0.05). Total complications: 21/122 (17%); within 30 days: 15/21 (71%). Reconstruction type was not associated with total complications, though local flaps exhibited more complications within 30 days. Complication rates amongst local flaps were significant: transposition 8/15 (53%), multiple 3/15 (20%), rotation 2/15 (13%), interpolation 1/15 (7%), and advancement 1/15 (7%). Common complications included pincushioning 3/15 (20%) and scarring 3/15 (20%). Staged reconstructions had no change in complications; total staged: 28/122 (23%); complications 7/28 (25%). The median time from resection to reconstruction was 1 day (0-716 days), which had no association with complication rate.

Conclusions: Mohs facial defects repaired with transposition flaps exhibited the most complications, though major complications were rare. Staged procedures and reconstruction timing demonstrated no association with complication rate. Mohs defects can be repaired with myriad alternative flaps that necessitate various repair stages and time frames.

    Presenting Author(s)

  • AL

    Alexa L. Lacy, MD

    Resident Physician
    Atrium Health Wake Forest Baptist, Department of Otolaryngology- Head & Neck Surgery
    Winston-Salem, NC, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • SM

    Sarah A. Martin, BS

    Medical Student
    Wake Forest University School of Medicine
    Winston-Salem, NC, United States

    Disclosure information not submitted.

  • Kyle S. Hrabovsky, BS

    Medical Student
    Wake Forest University School of Medicine
    Winston Salem, NC, United States

    Disclosure information not submitted.

  • Jane B. Cleland, BS

    Medical Student
    Wake Forest University School of Medicine
    Winston-Salem, North Carolina, United States

    Disclosure information not submitted.

  • BV

    Binathi Vuppuluri, BS

    Medical Student
    Wake Forest University School of Medicine, United States

    Disclosure information not submitted.

  • HH

    Hattie Hoffman, BS

    Medical Student
    Wake Forest University School of Medicine, United States

    Disclosure information not submitted.

  • MM

    Musa Malik, BS

    Medical Student
    Wake Forest University School of Medicine, United States

    Disclosure information not submitted.

  • BN

    Bianca Nolde-Lopez, BS

    Medical Student
    Wake Forest University School of Medicine
    Littleton, Colorado, United States

    Disclosure information not submitted.

  • KR

    Kyle Robinson, MD

    Academic Faculty Physician
    Atrium Health Wake Forest Baptist Medical Center, United States

    Disclosure information not submitted.

  • BD

    Brian W. Downs, MD

    Associate Professor
    Wake Forest Baptist Health Department of Otolaryngology
    Winston-Salem, NC, United States

    Disclosure information not submitted.

  • Candace M. Waters, MD

    Assistant Professor
    Wake Forest School of Medicine
    Winston Salem, NC, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • AS

    Allison A. Slijepcevic, MD

    Assistant Professor, Otolaryngology
    Atrium Wake Forest Baptist Medical Center, United States

    Disclosure information not submitted.