When it comes to skin cancer of the face and neck, reconstruction is important not only to preserve the aesthetic aspects of the face but also preserve the function of the important structures of the face and neck. These structures include the eyes, nose, cheeks, forehead, ears, and neck.
Typically, coordination of the skin cancer surgery is done prior to removing the skin cancer. Our office can help coordinate the date and time of the MOHS resection and reconstruction with your MOHS surgeon / Dermatologist. 95% of all reconstructions can be done in the office under local anesthesia. Let us know if you would rather have it done with twilight or general anesthesia. During your consultation, reconstruction options will be thoroughly discussed. There are always a few options for closing defects, from advancing skin from around the defect to skin grafts to vascular flaps. Our surgeons will guide you through the process and help you decide which closure is best for you.
First, the skin cancer is resected at the dermatologist’s office. Once margins are found to be clear through the MOHS technique, bandages are applied, and patients head over to our office. Because the timing can’t be predicted on how long it will take to get clear margins on the resection, patients are typically scheduled at 4:30 the same day or next. The closure is typically done under local anesthesia. The only part that is uncomfortable is anesthetic infiltration. Once numb, the closure is performed. Once the closure is complete, sutures are used to keep the defect closed. A dressing is then applied. Typically, but not always, the dressing and sutures are removed around post-op day 7. Swelling is common post-op. Occasionally medicated injections can be used to control and help the swelling.