What is Mohs Reconstruction?

Mohs reconstruction surgery is a procedure where, after skin cancer on the face is removed, the area is reconstructed to help restore the facial appearance and aesthetic.

Skin cancer can mean the loss of any facial tissue, including the skin, fat, muscle, or deeper tissues of the nose, lips, cheeks, forehead, or eyes. Dr. Westreich works in conjunction with your dermatologic surgeon to remove the cancer and rebuild the facial features that the cancer damaged. The first step of this procedure is Mohs surgery, which addresses and removes the cancerous lesion.

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What Happens During Mohs Surgery?

Skin cancer is first removed by a dermatologic surgeon using Mohs Micrographic Surgery, the most advanced and effective treatment procedure for skin cancer available today. This technique allows maximum preservation of normal surrounding tissues by using real-time microscopic evaluation of the removed cancer. Cure rates with this technique can be close to 99%.

During Mohs, the entire malignant lesion can be precisely identified and carefully removed, layer by layer, leaving the surrounding healthy tissue intact. As the damaged skin layers are removed, each tissue layer is examined under a microscope for signs of cancer, allowing the area to be mapped accurately and precisely. When cancer cells are identified, the next layer of tissue is removed. Once a cancer-free sample is reached, the procedure is complete. This layer-by-layer removal of cells helps ensure that the healthy tissue surrounding the cancerous lesion is untouched and scarring is minimized.

This layer-by-layer removal of cells helps ensure that the healthy tissue surrounding the cancerous lesion is untouched and scarring is minimized. This advanced surgical technique requires more time than traditional surgery in some cases due to the added time for tissue examination. You can predict several hours for the procedure to be completed. Once the cancer is fully removed, the next step is Mohs reconstruction.

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What Happens During Mohs Reconstruction Surgery?

Although Mohs surgery can help preserve the most healthy tissue possible, some individuals may develop a notable defect after excision. Dr. Westreich can perform Mohs reconstruction to improve the appearance of a post-surgical disfigurement.

There are different ways that the Mohs reconstruction can be done. The reconstruction method depends on the extent of the cancer and the severity of the post-surgical wound. If the wound is relatively simple, Dr. Westreich will expertly and precisely close it to minimize any scarring, typically in the office.

In more complex cases, Dr. Westreich will employ sophisticated reconstruction techniques to restore the facial areas that were affected. He may rearrange the tissue by grafting skin or by using a local skin flap. The choice of flap or donor site for a skin graft can have a significant impact on the quality of the reconstructive outcome. Dr. Westreich will use the technique that is indicated to help ensure your facial features are left looking natural and restored.

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When is Mohs Reconstructive Surgery Needed?

Mohs surgery is most often used to treat common types of skin cancer, such as basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. Reconstructive surgery is usually done in conjunction with this. For some areas of the body that are hidden, a patient may choose to live with any remaining scars. However, for facial areas, it is typically very important to treat the area and restore a natural-looking appearance.

This type of surgery is typically used for cancers that:

  • Are large or fast-growing
  • Are likely to spread
  • Are likely to come back or have come back
  • Are on an area where it’s important to remove as little tissue as possible
  • Have borders or edges that aren’t clear

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Preparing for Surgery

When preparing for the procedure, dress in comfortable, loose clothing. Wear a top that buttons in front for easy removal without disturbing any treated area. Plan to have transportation home afterward from a friend or family member because after the surgery, you may have bandages that may restrict motion or vision.

You can eat breakfast during the day of your surgery. There is some waiting during the time when the removed skin tissue is evaluated, so bring a book, magazine, laptop or other form of relaxing activity.

What Can I Expect During My Recovery?

You may go home the same day with a friend once the surgery is over. You will have a dressing on the area to help reduce swelling, which you should leave in place for a day. You will experience swelling that increases over a couple of days and then reduces over the next week or two weeks. Although patients can return to normal activities within a couple of days, they are advised to refrain from strenuous activity for about a week until the sutures are removed. The skin will continue to heal over the course of a few weeks, possibly taking four to six weeks for the wound to heal completely, depending on the size of the area.

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