What Is Mohs Surgery Reconstruction?

Reconstruction after Mohs surgery can repair areas of the face that might have been impacted by cancer removal, including the lips, ears, eyelids, cheeks, and nose. However, the procedure is available for the rest of the face and body.

Who Is a Good Candidate for Mohs Surgery Reconstruction?

If you’ve received Mohs surgery, whether recently or longer ago, you’re likely eligible for a reconstruction. Your surgeon will require you to be healthy so your body can withstand the surgical procedure. You should also not currently be undergoing any cancer treatments.

What Is the Recovery Time for Mohs Surgery Reconstruction?

Plan to spend at least a week recovering after Mohs surgery reconstruction. You shouldn’t go to work or handle household chores or errands during this time. Focus on your recovery. You may notice surgical side effects, including swelling, bruising, irritation, and redness.

Your surgeon will advise you on post-surgical care, but many at-home remedies can alleviate the discomfort of your side effects. Using eye drops can lessen eye irritation, while a gel ice mask can treat the tender skin around the eyes.

Cold compresses can also reduce your pain, as can over-the-counter Non-steroidal anti-inflammatory drugs (NSAIDs). Your surgeon will likely recommend you elevate your head, which will require you to change how you sleep until your surgeon says otherwise.

Schedule Your Mohs Surgery Reconstruction Consultation with Andrew Trussler, MD

Andrew Trussler, MD is an Austin-based plastic surgeon specializing in Mohs surgery reconstruction. Set up a free consultation with him through the online contact form here or call us at 512-450-1077.

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1. Reconstruction after Moh’s Surgery can be performed the same day of the excision. Many Moh’s specialist can predict the need for reconstruction based on the initial size and location of the skin cancer. With careful planning and communication with both the Moh’s surgeon and the reconstructive plastic surgeon, a day in which the Moh’s surgery is performed in the morning and then the closure is planned in the afternoon can be realistic. Variables which can make this difficult, are the need for multiple rounds of Moh’s surgery to completely remove the cancer and the availability of the operating room if not reserved before the procedure. Typically in these cases, the closures can be performed the next day by the reconstructive surgeon.
2. The procedure can be done in the office or in the operating room. The closure of certain simple defects after Moh’s surgery can be performed in the office under local anesthesia by either the dermatologist or the plastic surgeon. Typically smaller open wounds in uncomplicated areas can be closed with simple manipulation of the local tissue to achieve a straight-line closure with stitches.
3. The complexity of the reconstruction depends on size of the area. Small open areas for Moh’s procedures can be closed easily though this does relate to the area of the defect. Large areas on the trunk or limbs may be covered with skin grafts, but often they can be closed with rotation or pedicled flaps. Large areas of the nose may need three dimensional reconstruction with a forehead flap and a lining flap, in order to maintain form and function of the nose. The larger the area of the Moh’s defect the less straightforward the repair.
4. The complexity of the reconstruction depends on the location of the defect. The most common areas for Moh’s procedures are typically common areas of skin cancer, including the nose, ears and forehead. Unfortunately, these areas do not tolerate straightforward  repairs for open areas 5 mm or more. For Moh’s defects of the face, eyelid, cheek, lip, ear and nose: reconstructive surgery with either a flap or graft are often indicated. The type of reconstruction is based on the size of the defect in this area, but the majority of open areas in these regions require reconstructive surgery by a plastic surgeon.
5. Reconstructive surgery after Moh’s surgery may require additional procedures. Simple repairs after Moh’s surgery may need very limited care after the stitches are removed. Scar care is important for any incision and Dr. Trussler will guide you on his active scar care regimen. For some flaps and grafts used to fill in open areas, dermabrasion and laser resurfacing may be needed to flatten and blend the new skin into the surrounding area. These are commonly in-office procedures. Pedicle flaps often require a division and insetting procedure where the pedicle composed of skin and blood vessels is divided and the living flap is completely sutured to the open wound. This is commonly done at the 3 week point and is a short out-patient procedure, where fine touches can be made to the contour of the flap. Some residual scarring and donor site areas can be revised at the 6 month to one year point if needed on certain areas.

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