Reconstruction after Mohs or Skin Cancer Surgery

Advanced Techniques for Optimal Results

The facial plastic surgeons at University Hospitals use a variety of reconstructive techniques after skin cancer removal. The goal is not just to restore a natural appearance. Our experts work to ensure that facial structures like the eyes, nose and mouth function as they should after surgery, with patients able to breathe through the nose, blink properly and smile without distortion.

The reconstruction process is highly personalized for each patient. During the initial assessment, the surgeon will consider factors like wound size and location, skin texture and thickness and proximity to critical structures like nerves and cartilage to decide the best approach. Techniques may include:

• Skin flaps. This is a common technique for areas like the nose or eyelids in which nearby skin is shifted or rotated to cover the defect. If the surrounding skin is very taut, tissue expanders may be used prior to the surgery. The expander is placed beneath the skin near the damaged area and gradually filled with saline solution, causing the skin to stretch. This ensures the surgeon has enough available skin to close the defect with less tension, creating a more natural look.
• Skin grafts. Also known as free tissue transfer, this procedure is the preferred method of repair for larger wounds. It involves taking skin from another area of the face, like behind the ear, and grafting it to the wound site. Although the skin tone at the repair site may be slightly different in color or texture, this variation will typically become less noticeable over time.
• Cartilage grafts. If the Mohs procedure is extensive, it can sometimes compromise the structural integrity of areas like the ears or nose. Surgeons may borrow cartilage or tissue from another part of the body to rebuild the structure before covering it with skin.

Recovery from Facial Reconstruction after Mohs Surgery

Stitches typically come out in a week or two but swelling and redness might linger longer. Patients are advised to avoid sun exposure and follow wound care instructions carefully to optimize healing.

Although scarring is usually minimal, if there is a scar, modern techniques like laser therapy or steroid injections after surgery can soften them over time.