Staged reconstruction of a tessier number 4 facial cleft

Tessier number 4 cleft is an extremely rare facial cleft. We report a case of Tessier number 4 facial cleft recently managed in our center. The approach to facial clefts is multi-disciplinary and may differ between centers. Multiple surgical interventions are required as well as a good psychosocial support. The child underwent a craniofacial reconstruction at 6 months of age, followed by a left macrostomia repair 9 months later and transcranial correction of the right orbital dystopia with eyelid reconstruction

Reconstruction Options Following Wide Excision of Basal Cell Carcinoma of the Face

Basal cell carcinoma is the commonest skin malignancy diagnosed in Malaysia. Surgery is the recommended treatment of choice with the lowest failure rate provided a clear margin is obtained. However, the defect may be too large to be repaired primarily. Formal reconstruction using grafts and flaps should be done to achieve the optimal aim of maintaining the integrity, function and cosmetic patient outcome. Three reconstructive methods are described in this series to restore the facial defect following the wide local excision. The procedures described were peri-alar crescentic advancement flap, nasolabial rotational flap and full thickness skin graft using supraclavicular skin. This series highlights the usage of the procedures based on solid foundation and principles, without compromising the desired outcomes for the patient.