Most facial skin cancers are basal cell carcinomas (BCCs) 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. The lesion is excised as an ellipse placed parallel to the natural expression lines (Figure 37.1), and closed without tension or distorting structures such as the eyebrow. The skin incision is made perpendicular to the surface and the wound is closed in layers. The wound edges are undermined as necessary.