Reconstruction

Abstract

Following surgical removal of lentigo maligna (LM) or lentigo maligna melanoma (LMM), confirmation of negative histologic margins is of primary importance, given the frequent propensity of LM/LMM to have significant subclinical extension. The reconstructive surgeon is often tasked with repair of a large defect, most commonly on the head and neck area. The cheek and nose are the most frequent sites involved, and require consideration of different reconstructive principles. Maintaining respect for anatomic subunits when planning reconstruction of any area is a key concept, particularly for nasal defects. Various techniques utilized in the repair of LM/LMM surgical defects include secondary intention healing, primary closure, skin grafts, local flaps, regional flaps, and occasionally free flaps. This chapter will describe advantages and disadvantages as well as appropriate application of this range of techniques.