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A patient with a Clarks Level II Melanoma of the forehead.   A 1 cm margin was outlined around the lesion. Abstract for Melanoma Guidelines of Care
 
Article for Staging of Melanoma

Defect after Excision. 
A large scalp rotation advancement flap is created.  The scalp has very little stretch and thus a large flap is required.

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This picture shows the final closure

The 2 week post op result.  Note the small dog ear.  If this does not flatten with time, excision can be performed in the office under local anesthesia

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The 6 week post op result.  Note that the dog ear has flattened.