After having Mohs surgery to remove a skin cancer lesion, your Mohs surgeon may perform a simple closure, or they may choose to refer you to a plastic surgeon for your post-Mohs reconstruction surgery. It is important to understand that there are multiple methods for performing post-Mohs reconstructive surgery since the locations, amounts, and types of tissues affected differ from patient to patient. However, the most commonly used techniques include:
- Flap techniques (the most commonly used technique in post skin cancer facial reconstruction)
- Bone grafting (Bone is taken from the skull and shaped to be placed into the excision site.)
- Cartilage grafting (The most common donor site is the ear, but rib cartilage is also used.)
- Tissue expansion (used in a small percentage of cases)
- Skin grafts (used infrequently for facial reconstruction)
Skin cancer reconstruction may be performed under local anesthesia, intravenous sedation, or general anesthesia. Your doctor will recommend the best choice for you. The wound is closed.(JOHN A, did you mean to plop that there? Should we say it’s simple because the wound is closed?) If your procedure has been a simple excision, this is a relatively straightforward process. If, however, more complex Mohs surgery was required, there are a number of options to repair the resulting defect left behind after removal of the lesion. Regardless of the techniques used, your plastic surgeon will take care to ensure that the resulting suture line is positioned in the best possible way to follow the natural creases and curves of the face in order to minimize the appearance of your scar.
It is important to note here that in approximately 15% of cases, reconstruction after skin cancer excision must be performed in two stages. This is true mostly when certain types of flap techniques are used. The first stage creates and repositions the flap, and the second stage sections or separates the flap from its original location and blood supply. Therefore, once you have recovered and blood supply to the wound has been sufficiently established, a second surgery may need to be scheduled to complete the reconstruction.