Arch Craniofac Surg.  2021 Jun;22(3):135-140. 10.7181/acfs.2021.00206.

Does reduction of the oncologic safety margin for facial basal cell carcinoma result in higher recurrence rates?

  • 1Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea


Wide surgical excision is the gold standard for basal cell carcinoma (BCC) treatment. Typically, resection requires a safety margin ≥ 4 mm. We aimed to confirm BCC excisions’ cancer recurrence rate and safety on the facial region with new safety margins.
We included patients with primary BCC on the facial region who underwent wide excision with 2- or 3-mm safety margins at our institution between January 2010 and December 2018. Medical records were reviewed to confirm the epidemiology and surgical information. Recurrence was confirmed by physical examination through regular 6-month follow-up.
We included 184 out of 233 patients in this study after applying the exclusion criteria. The mean age and follow-up period were 71.2± 10.2 years and 29.3± 13.5 months, respectively. The predominantly affected area was the nose (95 cases); a V-Y advancement flap was the most commonly used surgical method. There were two cases of recurrence in the 2 mm margin group and one recurrence in the group resected with 3 mm margins.
In this large cohort study, we found 2–3 mm excision margins can yield enough safety in facial BCCs. The recurrence rates were found to be comparable with those reported after wider margins.


Basal cell carcinoma; Local neoplasm recurrence; Resection margin; Skin neoplasms
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