Postoperative Margin Management After Conventional Excision of Facial Basal and Squamous Cell Carcinomas: A Histotype‐Specific Framework

Background: Postoperative management of close or positive margins after conventional excision of facial nonmelanoma skin cancer is challenging, especially in elderly patients and anatomically constrained sites where re-excision may impose functional or aesthetic morbidity. Methods: We retrospectively analysed 238 facial carcinoma cases treated by conventional excision at a peripheral ENT unit, including 172 basal cell carcinomas (BCC) and 66 squamous cell carcinomas (SCC). Margins were classified as clear, close or positive. Outcomes were analysed descriptively; two-sided Fisher exact tests were used as exploratory descriptors of distributional imbalance under sparse-event conditions, not as tests of treatment superiority or equivalence. Results: In BCC, no recurrence occurred after clear margins (0/90). Among non-clear-margin BCCs, recurrence remained uncommon after structured surveillance (5/65) and early re-excision (1/17). In SCC, recurrence occurred only after positive margins (3/15), with none after clear or close margins. Conclusion: The findings support histotype-specific postoperative interpretation of margin status after conventional facial skin cancer excision. In this cohort, selected lower-risk BCC cases were managed through structured surveillance, whereas SCC recurrence was confined to positive-margin cases, supporting a lower threshold for timely re-excision or equivalent oncologic management when clinically feasible.