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Skin Cancer and Mohs Reconstruction

Skin is the largest organ in the human body. It is our outer protective barrier, and as such the skin gets exposed to all of the elements. Over time damage from the sun, environmental exposures, and even just the normal cellular turnover process can lead to skin cancers. Whether due to exposure, genetics, or just bad luck, these skin cancers need to be removed with a margin of safety. Our surgeons have vast experience in reconstructing cancer defects from head to toe, and everywhere in between.

Our surgeons work with many of the area’s best dermatologists in diagnosing and managing skin cancers. Oftentimes concerning lesions are first biopsied by a patient’s dermatologist or primary care physician, and then referred for removal and reconstruction. This can take place in the office under local anesthesia, or in the operating room with further sedation for larger and more complex lesions. When skin cancers are located in areas where remaining skin is precious (eyelids, lips, nose), your surgeon may coordinate with a special dermatologist, a Mohs surgeon, to ensure precise removal and clearance of the cancer prior to reconstruction.

Our surgeons help treat all forms of skin cancer including basal cell, squamous cell, and malignant melanomas. Reconstruction blends oncologic (cancer) and aesthetic concerns, working to obtain the most functional and cosmetically concealed closure as possible. A variety of techniques are utilized, including complex closures, local or regional tissue flaps, or skin grafts as necessary. Postoperative scar care will be discussed to optimize your recovery.

Skin cancer removal and reconstruction:

  • Ensures eradication of the skin cancer
  • Typical closures along natural wrinkle lines
  • Maintains optimal function and cosmesis
  • Allows for ongoing monitoring and surveillance.

Quick Facts:

  • Length: 30-90 min
  • Anesthesia: General, sedation, or local

Outpatient

  • Recovery: 3-7 days
  • Side Effects: bruising, swelling, soreness

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SKIN CANCER REMOVAL AND RECONSTRUCTION TECHINQUE:

At your first consultation visit, your surgeon will review the pathology report with you and examine the area of concern. Using an erasable marker, they will draw the margins of normal skin that need to be removed as well as the planned closure directly on your skin. They will discuss all applicable reconstructive options to help you get the best outcome possible. Photos will be obtained and you will be scheduled for your excision and/or reconstruction either in the office or operating room depending on your desires and reconstructive complexity. Dissolvable sutures that do not need to be removed are typically used for most cancer reconstructions. Skin grafts may require special splints and care that your surgeon will discuss with you.

RECOVERY FROM SKIN CANCER RECONSTRUCTION

Smaller cancers that are removed and closed in the office typically have minimal down time of only 1-3 days. Larger areas may be sore for a few days, but most often Tylenol or a mild narcotic such as Tramadol is all that is needed to remain comfortable in your recovery. You will want to avoid heavy lifting or straining for a few days prior to returning to more normal activities. Often patients can shower the next day.

FAQS:

A: No. Mohs surgery is a special technique used most commonly for certain cancers of the eyelids, nose, and some areas of the face. This is performed by a Mohs surgeon (dermatologist) using a technique to remove a minimal amount of extra skin and test the margins while you wait in a recovery area. This is important where skin is most precious or there is no excess. Since only a tiny amount of normal skin is removed along with the skin cancer, additional excision or stages may need to be performed the same day until the cancer is fully removed. Our surgeons work with many Mohs dermatologists to perform reconstruction or closure of the more complex cancer defects. Often this is coordinated for the following day either in our office or the operating room as needed.
A: Unfortunately yes. Whether from bad luck, genetics, or environmental exposures, having one skin cancer means you do have a higher risk to develop subsequent skin cancers. Thus, our surgeons always recommend you maintain routine check ups with your dermatologist, as well as ongoing sunscreen, sun avoidance, and self skin checks.

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