Repair of a glabellar and inferior forehead defect.

This 44-year-old healthy white male was referred to our office for the treatment of a recurrent basal cell carcinoma clinically involving the left inferior forehead extending down to the left glabellar region of the face. The preoperative size of the tumor was 1.5 x 1.5 cm (Figure 1). The lesion had been present since 1998 and had undergone previous liquid nitrogen treatment and, subsequently, excisional surgery. The patient had no significant medical history, and the only medication he had been taking was ibuprofen as needed. The patient did not smoke, nor did he have a history of diabetes. After discussing the various treatment options with the patient, he opted to undergo Mohs micrographic surgery. After two stages, the tumor was fully removed, and the defect measured 2.0 3 2.3 cm (Figure 2). The postoperative defect extended through the frontalis muscle superiorly and the procerus muscle inferomedially, down to the periosteum. The left corrugator supercilli muscle was spared from removal. How would you manage this wound?