Single Stage Excision and Thick Split Thickness Skin Graft Technique for Facial Giant Congenital Melanocytic Nevi with Consideration of Facial Aesthetic Subunits: A Case Report and Literature Review

Abstract

Due to their three-dimensional anatomy, functional importance, and esthetic appeal, giant congenital melanocytic nevus (GCMN) of the face pose the greatest challenge to reconstructive surgeons, especially when there are few donors and a significant deformity. A 25-year-old male patient presented with a facial GCMN. GCMN management involves complete nevus removal and reconstruction using tissues of the same color, thickness, and as the surrounding skin. Some defect closure options were inapplicable due to the almost complete forehead defect. This study aims to report the author's successful experience treating an adult case of GCMN with single-stage excision and subunit facial restoration using thick split-thickness skin graft (STSG). In this case, thick STSG is considered to prevent the risk of secondary contracture and conspicuous discoloration. In addition to esthetic and functional outcomes, the patient's social status and self-esteem also improved. This technique promises esthetic results, such as reduced downtime, and improved psychological function.