Functional and Aesthetic Outcome of Mustardé Rotational Flap Reconstruction Following Wide Local Excision of Facial Squamous Cell Carcinoma: A Case Report

Abstract

Cutaneous squamous cell carcinoma is the second most common non-melanoma skin cancer and frequently involves sun-exposed areas such as the face. Surgical excision with adequate oncological margins remains the mainstay of treatment, while reconstruction of facial defects requires careful planning to preserve both function and cosmesis. We report a case of a 39-year-old female who presented with a non-healing ulceroproliferative lesion over the cheek for four months. Clinical examination revealed a 4 × 4 cm lesion with everted margins, indurated base, and necrotic unhealthy tissue. Edge wedge biopsy confirmed well-differentiated squamous cell carcinoma. The patient underwent wide local excision with a 1 cm margin, resulting in a post-excision defect measuring approximately 5 × 4 cm. Reconstruction was performed using a Mustardé rotational cheek flap. The flap provided good colour and texture match, reliable vascularity, and adequate coverage of the defect. Postoperatively, there was no flap necrosis, infection, wound dehiscence, or ectropion. At follow-up, the wound had healed well with satisfactory functional and aesthetic outcome and no evidence of recurrence. This case highlights the usefulness of the Mustardé flap as a reliable reconstructive option for moderate-sized cheek defects following oncologic excision.