Serial Skin Grafing Technique for Management of a Facial Giant Congenital Melanocytic Nevus: Case Report with a Literature Review.

We present a case report of a 6-month-old infant with a giant congenital melanocytic nevus (GCMN) covering 50% of the face. The treatment of choice was a serial resection with skin grafting. The first surgery encompassed excision from the nose and the right and left infraorbital areas. Full-thickness skin graft (FTSG) harvested from the left inner arm was engrafted. During the second surgery, the GCMN was excised from the left cheek, which was reconstructed with a fasciocervical advancement flap elevated in a superomedial direction. The third surgery encompassed excision from the forehead, left temporal region, right cheek, and left lower eyelid. The area was covered with an FTSG from the right inner brachium. At the age of 3 years, resection from the left eyelid, skin grafting, and temporal tarsorrhaphy were performed. The orbicularis oculi were released 1.5 years later and the lower eyelid was reconstructed with a fragment of a cartilage graft from the auricular conchae. Following the patient's complete healing, their quality of life was evaluated through Pediatric Quality of Life Inventory report for toddlers. A pleasant aesthetic result was achieved, satisfying both parents and the child.