ABSTRACT
Most facial skin cancers are basal cell carcinomas which are well demarcated and do not extend below the deep dermis. These lesions can be excised with a margin of 5 mm and the depth of incision is located at the level of the muscle fascia. For intraconal lesions, Tenon's capsule may need to be incised lateral to the limbus with dissection over the globe to the muscle insertions. Nasal tip lesions usually require full-thickness skin excision and if there is tumour extension to the deep dermis, cartilage should also be included in the resection. Access to the medial orbit and ethmoid sinuses for resection of extensive tumours usually involves a combined craniofacial approach from above and access through the naso-orbital region. Lateral orbital masses, usually epidermoid or dermoid cysts or tumours arising from the lacrimal gland, are approached through brow, eyelid or coronal access incisions.
