Mohs Defect Reconstruction

Mohs surgery is one of the leading skin cancer treatment options. This innovative surgical technique allows surgeons to remove cancer cells while minimizing the impact on surrounding, healthy tissue. Even though this procedure is conservative compared to traditional surgical excisions, there will still be a loss of healthy tissues. Mohs surgery may leave marks, indentations, scars, and deep pits in the skin that are unsightly, especially when skin cancer is removed from the face. In these cases, Mohs defect reconstruction surgery may be recommended to restore the lost tissue and improve appearance. On this page, you can learn more about what Mohs defect reconstruction is and what to expect from this procedure. If you want more information or you’re interested in getting started with this surgical treatment, Plastic & Reconstructive Surgery – a division of U.S. Dermatology Partners is here to help. Don’t hesitate to reach out to ask any questions you may have or schedule a consultation with one of our knowledgeable surgeons.

What Is Mohs Defect Reconstruction?

Mohs micrographic surgery is typically performed by a dermatologist as part of skin cancer treatment. The surgery involves removing thin layers of the cancer lesion and small amounts of surrounding tissue. As each layer is removed, it’s carefully examined under a microscope. The process is repeated until there are no cancer cells present in the layer of removed tissue. Compared to traditional surgical skin cancer removal, this process does help to retain healthy tissue, but defects may still be present. In this situation, a patient can work with a plastic surgeon to help close the wound or hole that is left after the Mohs procedure. Many patients opt to have Mohs defect reconstruction performed immediately after their skin cancer removal with the dermatologist, while other Mohs defects may benefit from closure with a facial plastic surgeon. Most commonly, the Mohs repair with facial plastic surgery would be performed 1-2 days after the Mohs procedure. Consult with your Mohs micrographic surgery provider to determine the best course of action for your particular case.

Depending on the results of the Mohs surgery, a variety of reconstructive surgical techniques may be utilized. Considerations before reconstruction planning include the size and location of the surgical defect and scar visibility. In some cases, a skin graft, using tissue from another location, is performed to replace the lost structure. In other situations, a skin flap, which uses adjacent tissue to cover the defect, may be recommended. For those whose Mohs surgery defect goes deeper, a cartilage graft may also be needed to fully restore structure. Other procedures may be recommended depending on the patient’s specific needs.

Benefits of Mohs Defect Reconstruction

The main benefit of Mohs defect reconstruction is clear – the restoration of a patient’s appearance following surgery. For those patients whose skin cancer is removed from the face, Mohs defect reconstruction may be especially beneficial. Repairing Mohs defects can also improve confidence and help patients move forward following skin cancer treatment.

Recovery After Mohs Defect Reconstruction

Immediately following your Mohs defect reconstruction surgery, you may notice some swelling and pain. This is a normal part of the healing process. For the first week, change bandages and dressings regularly and keep the area clean as instructed by the surgeon. For most people, over-the-counter pain medications are adequate to manage discomfort, but prescription pain medications may be prescribed as needed. Within a week, any stitches will be removed, and swelling and discomfort typically begin to diminish as well. Most people can return to work around this time, and they can gradually add more activity as tolerated over the next two to three weeks.

Every person heals differently, so the amount of time it takes to recover will vary. After your procedure, your surgeon should provide a healing and aftercare plan to guide you through the process. Following all instructions is essential to ensure you make a full recovery with minimal discomfort.

Risks Associated with Mohs Defect Reconstruction

Any surgery comes with some risks, but Mohs defect reconstruction surgery, when performed by a qualified professional, has significantly low risk.

While Mohs defect reconstruction is considered a safe procedure, some risks and concerns patients should be aware of before getting started include:

• Poor wound healing – skin grafts and other repairs can be rejected by the body, or the site may not heal well in general.
• Infection – look for skin that is warm to the touch around the surgical site, fever, nausea, chills, and other common signs of infection.
• Excessive bleeding – if the surgical site continues to bleed after the first few days, contact your surgeon.
• Numbness – loss of sensation in the treatment area is common during healing and can be permanent.