BACKGROUND: Distortion of the philtrum, which lends considerable symmetry to the midface, leads to a poor esthetic outcome. OBJECTIVE: This case series describes reconstructive approaches to six philtral defects after Mohs micrographic surgery. Reconstructive approaches including advancement flaps, full-thickness skin grafts, and second-intention healing are illustrated. Postoperative complications included graft hypertrophy, irregularity of the graft surface, graft color mismatch, tenderness, and slight eclabium, which improved with dermabrasion or intralesional triamcinolone. CONCLUSION: The reasonable success of full-thickness skin grafts demonstrated here provides an additional approach to philtral repairs, especially when combined with traditional advancement flaps.
BACKGROUND: Distortion of the philtrum, which lends considerable symmetry to the midface, leads to a poor esthetic outcome. OBJECTIVE: This case series describes reconstructive approaches to six philtral defects after Mohs micrographic surgery. Reconstructive approaches including advancement flaps, full-thickness skin grafts, and second-intention healing are illustrated. Postoperative complications included graft hypertrophy, irregularity of the graft surface, graft color mismatch, tenderness, and slight eclabium, which improved with dermabrasion or intralesional triamcinolone. CONCLUSION: The reasonable success of full-thickness skin grafts demonstrated here provides an additional approach to philtral repairs, especially when combined with traditional advancement flaps.