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Mohs Reconstruction

The removal of facial skin cancers including squamous cell carcinoma, basal cell carcinoma, and melanoma can leave large defects. Mohs micrographic surgery is often the procedure of choice for facial squamous cell carcinoma and basal cell carcinoma. Mohs micrographic surgery is an advanced technique employed by dermatologic surgeons that ensures complete removal of facial skin cancers while also minimizing normal tissue loss. Our facial plastic surgeons work closely with many local Mohs surgeons to coordinate your facial reconstructive surgery immediately following Mohs surgery. Dr. J. David Kriet and Dr. Clinton D. Humphrey work together with oncology colleagues in the University of Kansas Medical Center Department of Otolaryngology/Head and Neck Surgery to treat melanoma and provide aesthetic reconstruction after removal. Our doctors also perform revision surgery for many patients who have suboptimal scarring or healing after previous removal and/or reconstruction of skin cancer defects.

Mohs Surgery and Skin Cancer Reconstruction

Mohs surgery has proven to be a revelatory cancer removal technique for certain types of skin cancer. The process microscopically maps out the path of your skin cancer with precision and excises cancerous cells in the tissue one layer at a time. With each layer examined, the surrounding areas are checked for cancerous cells, and the tumor and its roots continue to be eradicated until cancer cells are no longer detected. This can all be achieved with minimal effects to surrounding healthy skin tissue.

Once all of the cancer cells have been confidently eradicated by Mohs surgery, the reparation and reconstruction of damaged skin tissue can take place. Dr. Kriet or Dr. Humphrey can assess the wound left after skin cancer surgery and devise the most optimal strategy to repair existing skin defects and restore a natural-looking appearance to the treatment area. As many skin cancers and carcinomas appear on the face, the expertise of a highly trained facial plastic surgeon is often necessary to precisely and effectively reconstruct the skin tissue. Aesthetics and proper functionality are pivotal to many facial areas affected by cancer, such as the lips, nose, and eyes. For this reason, it is essential to enlist the services of a surgeon who is experienced in restoring form and function to these areas for the best possible surgical outcome.

Approaches to Mohs Reconstructive Surgery

The approach utilized in reconstructive surgery depends on an array of factors, including the size of the cancerous lesion, the location, the types of tissues affected, and the depth of its roots. In general, Mohs reconstructive surgery may utilize:

  • Flap surgery: Flap surgery techniques transplant tissues that still have their blood supply intact from one site of the body to another. Flaps are comprised of skin, muscle, and fatty tissue. Depending on the most optimal location of donor skin tissue, your surgeon may utilize local flaps, regional flaps, or free flaps.
  • Skin grafting: Skin grafting removes a layer of skin tissue from a donor site and places it over an open wound or defect. Skin grafting is typically used for very superficial defects.
  • Structural grafting: When a facial defect is deep enough to affect the underlying cartilage, a structural graft may be necessary to repair the structure, replace the cartilage, and maintain the previous shape. Structural grafting can be necessary when cancer is removed from the ear or the nose.

Using these techniques, any scarring or disfigurement left in the skin tissue after Mohs surgery can be repaired or improved to achieve the best aesthetic result. Depending on the extent of your skin trauma, reconstruction may be performed in multiple stages. With the consultation of Mohs surgeons and oncology experts, our experienced facial plastic surgeons can formulate the most effective approach to repair the wound and minimize any visual scarring resulting from skin cancer removal.

If you are in need of facial reconstruction after Mohs surgery, please contact our Kansas City practice for a consultation.