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Mohs Reconstruction
Overview
Mohs reconstructive surgery is performed following Mohs micrographic surgery, a highly effective technique for removing skin cancer. While Mohs surgery focuses on precisely removing cancerous tissue, reconstruction restores both the appearance and function of the affected area—often the face, where preserving natural contours and symmetry is crucial.
Facial reconstruction may involve delicate repairs to the nose, eyelids, lips, or cheeks. The goal is to achieve optimal cosmetic and functional outcomes while minimizing visible scarring.
Indications
- Skin cancer has been removed using Mohs surgery and leaves a defect (wound) requiring closure
- The affected area is on a cosmetically sensitive or functionally important part of the face
- Tension-free healing or layered closure is necessary to preserve facial movement, expression, or breathing
- A patient desires the best possible aesthetic result post-cancer removal
Common skin cancers treated include:
- Basal cell carcinoma (BCC)
- Squamous cell carcinoma (SCC)
- Melanoma
Benefits
- Restores facial appearance after skin cancer removal
- Preserves or improves function (e.g., breathing, blinking, speaking)
- Reduces the risk of scarring or disfigurement
- Customized approach based on the size, depth, and location of the surgical defect
Description
After the Dermatologist/Mohs surgeon confirms clear cancer margins, Dr. Shehan repairs the surgical defect using a range of advanced closure methods. Depending on the size and location, the reconstruction may be done immediately after Mohs surgery or scheduled as a separate procedure.
Patients receive local anesthesia or general anesthesia, depending on the extent of the reconstruction. Postoperative care includes wound protection, scar management, and follow-up visits to monitor healing and cosmetic results.
Techniques Used
• Primary closure: Simple stitches used when the wound can be closed directly
• Local tissue flaps: Nearby skin is rotated or repositioned to cover the defect while preserving texture and color match
• Skin grafts: Skin taken from another area of the body (e.g., behind the ear) is used to cover larger or deeper wounds
• Cartilage grafts: Used when the nose or ear needs structural support
• Staged reconstruction: In complex cases, multiple procedures may be needed to refine both form and function
Frequently Asked Questions
Will I need reconstruction the same day as my Mohs surgery?
Reconstruction after Mohs surgery can be completed within 1-2 weeks after resection.
Will I have a scar?
Some scarring is inevitable, and reconstructive techniques aim to place incisions in natural creases or shadowed areas to make scars as discreet as possible. Scar appearance often improves significantly over time.
How long is the recovery time?
Most patients resume daily activities within 1 week, although full healing and scar maturation may take up to 1 year. Your surgeon will guide you on wound care and activity restrictions.
Do I need to see a specialist for facial Mohs reconstruction?
Yes. For facial areas—especially the nose, eyelids, and lips—it’s important to work with a surgeon experienced in facial reconstructive surgery to ensure both function and aesthetics are preserved. From her rigorous training in head and neck surgery, Dr. Shehan is highly experienced in this area.
Will my insurance cover the reconstruction?
In most cases, yes—Mohs reconstruction is considered medically necessary following skin cancer removal. Coverage depends on your insurance plan and the complexity of the reconstruction.