What to Expect with Graft on Face Due to Melanoma?

Melanoma skin cancer on the face can be life threatening. The extent of the reconstruction depends on the size and depth of the melanoma present. The size of the defect also depends on the location and whether or not there are any lymph nodes involved. The thickness of the melanoma will determine final treatment parameters. Most certainly there will be a scar present from the removal and any type of skin grafting necessary to close the defect.

Most common type of melanoma on face is lentigo maligna or melanoma in situ. However, there have been several reports of metastasis even in the case of melanoma in situ on the face so adequate margins should be taken to ensure the highest cure rate. Your surgeon along with your dermatologist may recommend lymph node biopsies as well depending on the depth of invasion of melanoma.
Cosmetically, flap almost always looks better than a graft, however, in the case of melanoma in situ or melanoma, graft may be preferable in case there is a positve margin as it would be much easier to go back and perform re-excision versus a flap where there can be significant amount of tissue movement. I am certain the procedure is performed in close coordination with a board-certified dermatologist who can perform Woods Lamp examination to better delineate margins of melanoma on the face. Topical imiquimod may be advisable to increase cure rate, better appreciate residual precancerous burden on the rest of the skin based on the amount of subsequent inflammation from imiquimod and possibly improve the appearance of surgical scar. Best wish.

This is difficult to say based on the information you have provided. Treatment is based on the thickness of the melanoma. Deeper melanomas require wider excisions. Wider excisions remove more tissue with greater risk for involving surrounding structures. Furthermore this will require a more extensive reconstruction.