Introduction: Facial giant congenital
melanocytic nevus represents a major cosmetic
deformity for the child and parents and is a challenge for the
plastic surgeons to achieve best cosmetic results. Herein, we present a case of single-stage surgical reconstruction using partial-thickness scalp skin graft aided with
Matriderm dermal substitute for a facial giant congenital
melanocytic nevus. Methods: An 8-year-old boy presented with a facial giant congenital
melanocytic nevus without leptomeningeal involvement. A single-stage complete excision of the
nevus was performed. A split-thickness skin graft, 12/1000-inch thick, was then harvested from the anterior scalp region for reconstruction. A 1-mm
Matriderm dermal substitute was first applied, on which functional subunit skin graft was then secured to cover the defect. Eyelid reconstruction was reconstructed separately using full-thickness postauricular skin grafts. Results: Histopathology of the excised specimen confirmed the diagnosis of congenital
melanocytic nevus, with no evidence of
melanoma. The donor area healed with a favorable
scar and no donor site morbidity or complications such as
alopecia or
hypertrophic scar. The postoperative result was satisfactory with minimal residual
nevus around the eye, and the patient was fully satisfied with the cosmetic and functional results. Discussion and Conclusions: Resection of facial congenital
melanocytic nevi, followed by single-stage reconstruction using
Matriderm and skin graft from the scalp, is an excellent and fast reconstructive method with promising aesthetic outcomes and greater improvement in physiological outcome, especially in the pediatric population.