Introduction: The most common type of skin cancer is basocellular carcinoma, which frequently occurs on the face.Aesthetic and functional damage during treatment are of great concern to patients; Mohs Micrographic Surgery is a safe treatment that allows tissular preservation with minimum aes- thetic damage. Objective: To evaluate whether using Mohs Micrographic Surgery to treat basocellular carcinomas located in aesthetically important areas of the face preserves healthy tissue. Methods: Surgical procedures (n = 49) performed in the ABC Medical School in 2008 to treat tumors located in the peribuccal, periocular and alar areas, and in the ears,were evaluated.The tumors were classified according to clinical and histological features, and the surgical margins were analyzed and compared to those recommended by the literature.The patients were re-evaluated 2 years after treatment. Results: The margins removed by Mohs Micrographic Surgery were much smaller than those recommended for excisional surgery, with important tissular preservation. Conclusion: Mohs Micrographic Surgery permitted the preservation of healthy tissue (56-86%) in the treatment of basocellular carcinomas located in aesthetically important areas of the face, with minimal damage.Thus it is a safe therapeutic and aesthetical option in the treatment of facial basocellular carcinomas.

Keywords: MOHS SURGERY, CARCINOMA, BASAL CELL, ESTHETICS, FACE, SKIN NEOPLASMS

Introduction: Calcium hydroxyapatite is a radiopaque material that was traditionally used to provide radiologic contrast. It has recently been approved for use in cutaneous filling.
Objectives: To define the radiologic characteristics of Calcium hydroxyapatite and its potential to compromise radiologic evaluations.
Methods: Twelve patients received Calcium hydroxyapatite filler in the malar eminence and had radiography of the face (frontal, lateral, mentum-nasal-plaque (Waters), and Hirtz axial incidence technique) 1-8 weeks after the procedure. The X-rays were examined by two radiologists – one of whom was unaware of the filling procedure.
Results: The Hirtz axial incidence technique demonstrated amorphous radiopaque images in the suprazygomatic soft tissues in all cases, in both evaluations. Radiesse® was not detected using the other techniques, and did not illustrate the filler''''''''s position and symmetry. The evaluation of subjacent osseous structures was not compromised by the material''''''''s presence.
Discussion: Calcium hydroxyapatite can be identified in facial radiography when evaluat- ed using a method that avoids overlapping with adjacent osseous structures. Although it does not impair the osseous evaluation, it is recommended that the radiologist or dentist is noti- fied of the material''''''''s presence.
Conclusion: Cutaneous fillings containing Calcium hydroxyapatite can be identified, although not precisely located, using conventional X-ray.

Keywords: FACE, DURAPATITE, X-RAYS

Introduction: Patients (n = 56) received incobotulinumtoxinA for the treatment of dynamic facial wrinkles.
Objective: To test the efficacy of incobotulinumtoxinA in correcting facial wrinkles.
Methods: The toxin was applied in in the usual doses and regions.
Results: Only 38 patients returned for evaluation after treatment. Of those, 19 complained about the low efficacy, short duration or absence of effects of the toxin. The total dose applied in patients who expressed satisfaction with the outcome (19 patients) was 872 units, while in the dissatisfied group (19 patients) it was 748 units – which was later increased by an additional 30.62% (229 units) of the initial dose.
Conclusion: Although some clinical studies demonstrate that this botulinum toxin has an efficacy similar to others available, this study has not succeeded in reproducing that fact.

Keywords: BOTULINUM TOXINS, FACE, THERAPEUTICS

This article describes the case of a female hepatitis C patient who presented with a foreign body granuloma in the nasolabial folds and glabella five years after receiving an application of permanent dermal filler. The patient used interferon and ribavirin for treating hepatitis C for six months, and the granulomas appeared 30 days after the end of the treatment. Treatment with oral steroids was carried out, with a gradual improvement in the appearance of the skin.

Keywords: GRANULOMA, POLYMETHYL METHACRYLATE, FACE

Photography is an essential tool in the dermatologist's daily practice and can be used in various ways. From simple records of lesions verified in dermatological examinations to illustrations of a treatment's result, photographs document more clearly and concisely what is seen due to the utterly descriptive nature of this medium. Nevertheless, it is important to note that the present article refers specifically to what is known as Medical Photography, a type of photography that reproduces subject matter with maximum detail and relevant information. To achieve this, it is necessary to master the basics of photographic technique, including knowledge of available equipment and the fundamentals of digital technology, and also to establish a photographic routine that includes the standardization of the images.

Keywords: PHOTOGRAPHY, DERMATOLOGY, FACE, SURGICAL PROCEDURES

Introduction: Filling techniques are an important procedure in modern therapeutic approaches to rejuvenation, and are currently in wide use. Objective: To assist the practice of dermal filling procedures and reduce associated risks. Method: Division of the face into 22 regions in which filling procedures are indicated, providing detailed description of the nervous and vascular structures of each. Results: This didactic, practical, and detailed new division of the regions of the face highlights the possible risks related to anatomical features, thereby facilitating implementation, and reducing the risks and complications of filling techniques, such as the widely-feared amaurosis and tissue necrosis. Conclusion: Only a thorough knowledge of facial anatomy enables the safe realization of dermal filling procedures.

Keywords: ANATOMY, RISK ZONE, FACE.

Among the diverse reconstruction alternatives used in surgical wounds, those employing cutaneous grafts are implemented when the closure – primary or by second intention – is unfeasible or, due to other factors, flaps are not recommend. The repair of surgical wounds using partial thickness graft obtained from the scalp with a flexible blade is described in 3 cases of conventional exeresis (2 basal cell carcinomas in the nasal region and 1 case of squamous cell carcinoma on the dorsum of the hand). The technique yielded good aesthetic outcomes, both in the receiver and donor areas.

Keywords: dermatologic surgical procedures; skin neoplasms; scalp; carcinoma, basal cell; carcinoma, squamous cell; skin grafts

Non-melanoma skin cancer is the most common neoplasia in humans, and basal cell carcinomas (BCC) account for approximately 80% of cases. Cumulative exposure to ultraviolet radiation (UV) is the main risk factor associated to BCC, with a higher incidence in photoexposed areas, including the auricular region. The auricular region is a noble cosmetic unit, with anatomical peculiarities that lead surgeries to require the excision of a large amount of tissue, presenting a challenge for the dermatological surgeon. The authors present a case of helix reconstruction with a triple transposition flap.

Keywords: Carcinoma, basal cell; Dermatologic surgical procedures; Dermatology; Ear neoplasms; Ear, external

The lower eyelid is one of the sites most affected by basal cell carcinoma (BCC). We present an option of inner corner skin flap with oral mucosa graft for eyelid reconstruction after BCC excision. This tumor affects approximately 60% of the lower eyelid and shows complete lower lacrimal canaliculus involvement. The use of internal corner skin transposition flap and oral mucosa graft is safe. The technique is reproducible and with good postoperative evolution. Positioning and eyelid movement were restored, allowing tear drainage through the upper canaliculus with complete correction of the tears’ overflow (epiphora).

Keywords: Basal cell carcinoma; Skin Neoplasms; Dermatological Surgical Procedures; Surgical Flaps

O queratoacantoma (QA), apesar de frequente na prática diária, é um tumor que gera questionamentos. O aspecto mais intrigante associa-se à sua posição no limite entre malignidade e benignidade. A abordagem do tumor, bem como sua classificação, é controversa. Na definição da conduta, é importante levar em conta o potencial de transformação para carcinoma espinocelular. Desse modo, a excisão cirúrgica é a terapia de escolha, sempre que possível. Algumas situações merecem atenção adicional, como a imunossupressão associada. Neste artigo, relatamos um caso de QA gigante em um paciente com síndrome da imunodeficiência adquirida tratado com cirurgia micrográfica de Mohs.

Keywords: Ceratoacantoma; Retalhos Cirúrgicos; Neoplasias Nasais; Neoplasias Cutâneas; Cirurgia de Mohs; Síndrome de Imunodeficiência Adquirida; HIV; Imunossupressão

The reconstruction of nasal defects secondary to non-melanoma skin cancer represents a surgical challenge, especially in the nasal tip, due to its limited local laxity and possible asymmetries. There are multiple techniques to perform this closure, but most are flaps from distant locations that can lead to less aesthetic results. We present two cases of basal cell carcinoma on the nasal tip, where reconstruction with the east-west advancement flap was performed after tumor excision, with a modification of the flap in one of the patients, obtaining a good structural and aesthetic result.

Keywords: Surgical flaps; Carcinoma, basal cell; Nose; Dermatologic surgical procedures

Basal cell carcinoma is the most common skin cancer, most often found in the head and neck region. We present the case of a 47-year-old male patient with pigmented basal cell carcinoma in the right medial malar region. After confirmatory biopsy, the lesion was excised with a 5 mm safety margin, extending to the lower eyelid. Reconstruction was performed using the McGregor flap, a technique that enables effective tissue advancement with minimal tension, minimizing the risk of complications. The patient had an uncomplicated recovery with satisfactory oncologic, aesthetic, and functional outcomes, demonstrating the technique's efficacy in complex periocular reconstructions.

Keywords: Carcinoma, Basal Cell; Surgical Flaps; Dermatology; Surgical Oncology; Face; Skin Neoplasms

Large upper-third auricular defects present complex reconstructive challenges, requiring restoration of both form and function. We describe a single-stage technique combining an ipsilateral conchal cartilage graft for structural support with a tunnelized preauricular transposition flap for soft tissue coverage. This approach provides rigid support to enable the use of glasses and hearing aids, along with good color and texture match. In a 79-year-old patient with a 30 × 28 mm post-Mohs surgical defect, the method yielded a satisfactory outcome with preserved ear contour and function. Only minor issues, such as slight forward auricular displacement, were noted at 8-month follow-up.

Keywords: Mohs Surgery; Dermatologic Surgical Procedures; Carcinoma, Basal Cell

O fibroxantoma atípico (FXA) é um tumor mesenquimal raro que geralmente acomete pacientes com idade avançada, do sexo masculino, em áreas fotoexpostas. É mais frequente na cabeça e pescoço, mas também pode ocorrer no tronco e nas extremidades. Atualmente, é considerado um tumor benigno de diagnóstico por exclusão, com baixa taxa de recidiva e metástase. O tratamento é realizado com excisão cirúrgica, o que permite o diagnóstico por avaliação histológica e imuno-histoquímica.

Keywords: Tórax; Oncologia Cirúrgica; Dermoscopia; Neoplasias; Imuno-Histoquímica; Sarcoma

Reconstruction of the malar region poses a surgical challenge due to its aesthetic relevance and the need to preserve function. We report the case of a 75-year-old man with bilateral basal cell carcinomas of the medial malar region. After tumor excision, reconstruction was performed using advancement flaps: a McGregor flap on the right side and a Burow flap on the left side. Advancement flaps proved effective owing to their simplicity, favorable tissue mobility, and adaptability to facial aesthetic units. The patient had an uneventful postoperative course, achieving satisfactory functional and aesthetic outcomes, highlighting the value of these flaps in facial reconstruction.

Keywords: Surgical Flaps; Basal Cell Carcinoma; Surgical Oncology; Dermatology; Face