Serial Skin Grafing Technique for Management of a Facial Giant Congenital Melanocytic Nevus: Case Report with a Literature Review

Abstract

We present a case report of a 6-month-old infant with a giant congenital melanocytic nevus (GCMN) covering 50% of the face. The treatment of choice was a serial resection with skin grafting. The first surgery encompassed excision from the nose and the right and left infraorbital areas. Full-thickness skin graft (FTSG) harvested from the left inner arm was engrafted. During the second surgery, the GCMN was excised from the left cheek, which was reconstructed with a fasciocervical advancement flap elevated in a superomedial direction. The third surgery encompassed excision from the forehead, left temporal region, right cheek, and left lower eyelid. The area was covered with an FTSG from the right inner brachium. At the age of 3 years, resection from the left eyelid, skin grafting, and temporal tarsorrhaphy were performed. The orbicularis oculi were released 1.5 years later and the lower eyelid was reconstructed with a fragment of a cartilage graft from the auricular conchae. Following the patient's complete healing, their quality of life was evaluated through Pediatric Quality of Life Inventory report for toddlers. A pleasant aesthetic result was achieved, satisfying both parents and the child.

Keywords

facial reconstruction - melanocytic nevus - pediatric surgery

Authors' Contributions

A.C. contributed to supporting data curation, formal analysis, and investigation, while taking the lead in funding acquisition, project administration, resources, supervision, and validation, as well as supporting writing—review and editing. M.K. led conceptualization and data curation, supported investigation, and equally contributed to visualization and writing—review and editing. A.J. supported conceptualization and data curation, led the investigation, equally contributed to visualization, and took the lead in writing—review and editing. K.C. and M.K. supported conceptualization, data curation, formal analysis, investigation, and resources, as well as contributing to the original draft.

Publication History

Article published online:
13 March 2025

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