Facial microcystic adnexal carcinoma — treatment with a “jigsaw puzzle” advancement flap and immediate esthetic reconstruction: A case report

Figure 1 Pre-operative mass appearance and skin flap design. A: The patient’s facial appearance before surgery. She had undergone resection of a left upper lip tumor at another hospital 1 mo earlier. The pathological diagnosis indicated microcystic adnexal carcinoma with positive lateral and basal margins. The patient was admitted at this time for additional radical surgery. The photograph shows a longitudinal light red surgical scar lateral to the left upper lip with a length of approximately 3 cm; B: Preoperative skin flap design. The lateral subunit of the left upper lip was the targeted region for extended resection. A puzzle-type advancement flap was designed to fit the shape of this region on the left cheek. The triangular areas marked on the upper and lower sides are the dog-ear deformity expected to be repaired during the surgery.