Facial pigmented nevi and superficial tumors generally include the skin and its appendages, muscles, nerves, blood vessels, connective tissues, bones, lymph and other superficial tissues and organs. The presence or diagnosis can usually be clarified by visual observation and touch, and the final diagnosis depends on histologic examination. The following issues should be considered for surgical treatment. Anesthesia choice: The choice of anesthesia for superficial tumor surgery depends on the patient’s general condition, age, size, location and nature of the tumor. For benign tumors, if the scope is small, local infiltration anesthesia, local block anesthesia can be used, and basic anesthesia can be used for children. For malignant tumors, if the scope is larger and the repair is more complicated, general anesthesia is preferred. Incision design: The location of superficial tumor is relatively shallow, and the incision site is the site for resecting the lesion and restoring the appearance and function. In addition to complete resection of diseased tissue, incision design also requires minimal scarring after healing of the incision or wound, minimizing secondary deformities and reducing the impact on function. Therefore, the design of the incision should follow the principles of plastic surgery, so that the incision line after suture follows the direction of the skin lines or wrinkles, or you can choose to incise along the hairline or along the junction of the skin and mucous membranes, or incise at the natural folds, or choose to make an incision in the hidden parts. Scope of excision: For benign superficial tumors, as long as the margin of excision is reached to remove the diseased tissues completely, try to retain the normal skin tissues around the tumor for repair. For malignant superficial tumors, a certain range of normal tissues around the lesion should be excised according to the nature of the tumor, degree of malignancy, and the presence or absence of metastasis, in order to ensure the thoroughness of excision and prevent or reduce the chance of recurrence. In the facial area, due to the gathering of the five organs, inappropriate enlargement of the resection is prone to cause deformity and dysfunction of the organs, therefore, when considering the scope of resection, it is necessary to guarantee the thorough resection of the diseased tissues as well as to take into account the need to maintain a better facial appearance after the operation and to alleviate the secondary deformity. Principle of non-spreading operation: the resection of superficial tumors should follow the principle of aseptic and non-invasive operation, and in the case of malignant superficial tumors, the principle of non-spreading operation should also be strictly implemented. Adding appropriate amount of epinephrine in anesthetics can reduce bleeding, prolong the time of anesthesia effect, and also reduce the chance of hematogenous dissemination. Resection of diseased tissue is mostly performed by sharp dissection, starting from the proximal end of the vascular and lymphatic reflux and proceeding distally. Depending on the infiltration, the depth of excision of the lesion will determine whether or not the barrier composed of mesenchymal tissue, such as subcutaneous tissue, fascia, periosteum, and cartilage, needs to be removed. Intraoperative squeezing of the mass is avoided, which may lead to dissemination and migration of the tumor tissue. After resection of the diseased tissue, the trauma was immediately flushed with large amounts of isotonic saline. The surgical field is re-laid with sterilized towels and sheets, and the surgical gowns, gloves and surgical instruments of the surgical personnel are replaced before wound repair is carried out. Wound repair: Wound repair after resection of superficial tumor should be based on the principle of simple and convenient methods that can achieve better repair results. The surgical design should not be too complicated, so as not to increase too much incision scar and affect the appearance. The lesion excision should minimize the loss of normal skin, and the incision suture should be locally smooth and prevent the appearance of new deformity and deformation and displacement of the facial eyes, nose, mouth and other organs and body markings. Smaller tumors can be sutured directly after resection, if the trauma is large, pulling together the suture with greater tension, feasible skin or skin flap transplantation repair. For malignant tumors or recurrent lesions with a large scope, it is preferable to prefer skin grafting, so that it can be detected as early as possible once there are local abnormalities in the future, and local flaps may lead to dissemination of tumors and should be used with caution. Neighboring flaps can be used for immediate repair of early lesions and resections of facial organ parts that can also be more complete. Distal flaps, in addition to anastomotic vascular free flaps, due to the number of surgeries, the course of treatment is lengthy, unless there is a bone surface, dura mater or other important tissue exposure must be repaired by the flap of the larger defects, the neighboring and no skin supply conditions should be considered only when the application of the situation, generally should be the last choice.