Abstract
Reconstruction of surgical defects of the face following Mohs micrographic surgery (MMS) requires careful consideration of both functional and cosmetic outcomes. In this report, we present a complex case of biopsy-proven invasive Bowenoid squamous cell carcinoma with extensive lower lip involvement, resulting in a large musculomucosal defect after MMS. The defect was closed using a multilayered approach with local tissue advancement to reduce tension and eliminate the need for secondary donor sites. Long-term follow-up demonstrated excellent cosmetic and functional outcomes without evidence of recurrence.