Facial cutaneous reconstructive surgery: general aesthetic principles.

The performance of cutaneous reconstructive surgery requires understanding and application of many important principles. This article reviews the critical factors to consider in the management of surgical wounds by second-intention healing, primary closure, skin grafting, and repair with local flaps. For certain defects, reconstruction with local flaps offers several advantages over other alternatives. Key concepts useful in flap choice and implementation are discussed, and surgical techniques that maximize the aesthetic outcome of reconstructive surgery are reviewed.