Eighty-four patients with basal cell carcinoma of the head and neck were submitted to surgery. In 75 %, infiltration of the reticular dermis or the subcutis was documented. Primary closure of the wound was achieved in only one-third of these patients. In the remaining cases, the defects were closed by local flaps, regional flaps or a microvascular forearm flap. In 86 % of the cases, good-to-excellent results were achieved.