Facial Reconstruction After Mohs Surgery

Eileen Bailey Health Guide
  • Mohs surgery uses a specific technique that allows your surgeon to remove a cancerous lesion or tumor while taking the least amount of healthy tissue surrounding the tumor. During Mohs surgery, your doctor removes tissue, one layer at a time and examines each layer under a microscope. If cancer is still present, he will remove one more layer and look under the microscope again. This is continued until the surgeon determines that all the cancer has been removed.

     

    This type of surgery has several benefits. Most importantly, it is highly successful in removing all of the cancer. Secondly, it allows the surgeon to remove only the affected tissue, therefore creating a smaller wound than surgical excision, which usually removes a larger amount of healthy tissue surrounding the wound. Smaller wounds heal faster, giving you a shorter time for recovery.

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    Skin cancer often appears on the face since this is the area most often exposed to the UV rays of the sun. According to the Skin Cancer Foundation, the nose is the most common location for skin cancer. If you have skin cancer of the face, you might worry about your appearance after the surgery. Will you have a large scar? Will you look disfigured?

     

    The most common technique used to close your wound is called a flap technique. This is when skin adjacent to the wound is pulled over it and then sutured. Skin grafting, when skin is taken from a donor site on your body and sutured into place is avoided when possible as it is difficult to match skin from other parts of the body to the skin on your face. Depending on the location of your cancer, you might also need cartilage (if cartilage on your nose is damaged). If so, cartilage is often taken from your ear.

     

     Your doctor will make every effort to minimize scarring. Using Mohs surgery is the first step as it will leave a smaller scar. Many times, your surgeon will also close your wound and perform routine plastic surgery to lessen scarring. Other times, your surgeon will refer you to a plastic surgeon. He might have you speak with a plastic surgeon prior to your surgery so that all the surgery can be completed on the same day. Sometimes, a second surgery is needed. If this is the case, the plastic surgeon will tell you and make arrangements for follow-up care.

     

    If you do speak with a plastic surgeon before your surgery, make sure you provide your insurance information. While this procedure is usually covered by your insurance, you want to make sure and provide information ahead of time. The doctor’s office will check with your insurance company and let you know if there are any problems.

     

    References:

     

    “The Skinny on Mohs Micrographic Surgery for Skin Cancer,” Date Unknown, David G. Brodland, M.D., Skin Cancer Foundation

Published On: November 11, 2014