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A patient with a Squamous Cell Carcinoma of the Temple which has been removed with surgery.   Most cancers in this area are due to sun exposure.

A rhomboid flap is constructed.  The maximum pull on the tissue is shown by the green arrow. Because of tissue pull, the dimensions of the rhomboid are shorter in one direction than the other.

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In this patient, a square defect was excised.  This will increase the tension of the closure, but allow for closure with a smaller flap.  The defect was small so this did not pose a problem..  The flap was placed posterior and inferior to the defect.   In this location, the tension of the closure would not elevate the eyebrow.    An anterior placement, would result in eyebrow elevation and a placement of the scar towards the medial forehead.. 

  The flap is rotated into position and sewn in place.  Note that two of the lines of closure approximate the lines of the forehead.

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The 1 week post surgical result.

  2 month post operative result.