When it comes to cosmetically-delicate areas, the face and neck are especially sensitive. There are also areas of the body that are just as vulnerable. Unfortunately, due to repeated sun exposure, there are parts of the face like the ears, nose, eyelids, and lips that are especially prone to the development of skin cancer.
Skin cancer removal can leave scars and may disfigure highly visible areas of the face if they are not patched up with meticulous surgical detail. The Aesthetic Surgery Center offers skin cancer reconstruction for patients in the greater Naples and Fort Myers areas.
What is Mohs Reconstruction?
The Mohs surgical procedure is currently the most effective way to treat most common types of skin cancers, such as basal cell carcinomas, or BCCs, and squamous cell carcinomas, or SCCs.
Mohs ensures the removal of a carcinoma while sparing healthy cells. Scars are minimal with the procedure and cure rates are the highest recorded.
The procedure has a few stages, the last of which is Mohs reconstruction. This when a plastic surgeon may become involved in your care, to close your complex wound. This process is done with extreme care and aptitude. Many times, though all surgeries leave scars, you would be hard-pressed to find the remaining minuscule marking if you did not know it was there.
Skin Cancer Before-and-After Photos
Your dermatologist will decide if you are a candidate for Mohs surgery. The treatment is gentle enough to remove a carcinoma from a sensitive functional or cosmetic spot like the toes, fingers, scalp, eyelids, ears, lips, genitals, or nose. However, it is effective enough to combat an aggressive carcinoma over a large area that may be massive and indistinct. The procedure can even treat a carcinoma that has recurred after past skin cancer treatments have failed.
If you are planning to undergo Mohs surgery by a Mohs trained dermatologist, your dermatologist may call upon one of our plastic surgeons (Dr. Holmes, Dr. Agarwal, or Dr. Maloney) to assist with closing a complex defect.
Why Choose This Procedure?
There are many reasons to choose Mohs surgery. Here are just a few of the best justifications for considering it:
- It is an outpatient, one-time procedure
- Only requires local anesthesia
- All lab work is completed on-site
- Your doctor examines 100% of your tumor margins, guaranteeing precise results
- Barely leaves a scar and the process spares all healthy cells
- An effective treatment option that is not overly expensive
- Boasts the highest rates of cure, at 97-99% for new tumors and 94% for those that were previously treated
The Consultation at our Naples Office
Proper Mohs surgery is administered by physicians adept at three different roles. These are:
- the surgeon that removes the cancerous cells (a Mohs surgeon is a dermatologist generally with advanced training in Mohs surgery)
- potentially a pathologist that takes a look at the tissue in the lab
- the plastic surgeon that closes the wound meticulously with skin cancer reconstruction techniques
Plastic surgeons like Dr. Holmes, Dr. Agarwal, and Dr. Maloney are extraordinarily experienced at skin cancer reconstruction so Mohs scars will heal in as attractive a manner as possible. Dermatologists in our area achieve the highest cure rates through Mohs surgery. Afterward, they simply dress the wound and send patients to our office within a few days, to repair the area via Mohs reconstruction, so the wound will heal with the least scarring possible.
The Mohs Reconstruction Process
To understand skin cancer reconstruction, you will need to understand the whole surgical process. The Mohs procedure is completed in stages. Here is how it usually works:
Preparation and Examination
You may need to change into a hospital gown depending on where your cancer is located. Afterward, the dermatological surgeon will mark the area of your biopsy to find it easier later on. He or she will then position you in a way that will allow him or her the best access to the cancerous tissue.
Next, a surgical drape will be set in place over the area. If your face is the area in question, you will be unable to see anything, but your surgeon will narrate you through the procedure.
Then, a local anesthetic is injected, numbing the entire area.
Removing the Top Layer of the Cancer
The Mohs surgeon will remove a thin layer from the top of the tumor using a scalpel. Just remember, the cancerous lesion may have deeper roots than what is visible.
You will be temporarily bandaged while your tissue is sent to the lab.
Your Mohs surgeon divides the cancerous tissue into sections and uses dyes to color-code each of the segments. He or she also draws a map of the area to be operated on.
The tissue is frozen by a lab technician who also cuts it into very thin layers. Each piece is then placed on slides that will be analyzed under a microscope.
The doctor examines all parts of the tissue for skin cancer, including its edges and underside, to determine if further skin cancer cells remain. He or she then marks where they would be on the map. The surgeon will inform you if further removal is necessary.
Further Skin Cancer Removal
If more cancerous cells remain, the physician will inject more anesthesia and proceed to remove another layer of tissue where the map indicated they would be.
The above process repeats on a loop until no further cancerous tissue remains.
Sealing the Wound
While the wound can be left alone and allowed to heal on its own, a dermatologist may also close it with stitches. If the wound is too big or there is not enough skin to pull together, sometimes this means reconstruction using a skin flap, where nearby skin and tissue are moved into the wound. Other times, it could mean a complete skin graft from another part of the face or body. Sometimes the procedure involves multiple staged surgical procedures. Our plastic surgeons will analyze your wound and determine the best option to leave the least scarring and least functional impairment possible.
Patient Testimonials for Skin Cancer Reconstruction
It is crucial that you follow our directions when it comes to wound care. Remember, recovery and healing time are completely dependent on the type and scope of your Mohs reconstruction.
You may experience some tenderness or soreness post-surgery. Tylenol, however, should be strong enough to handle the discomfort. If you find that you may need a stronger pain reliever, our Naples plastic surgeons will most likely prescribe one for you. Bruising and swelling may also develop close to your wound. This is especially true if the surgery was performed close to the eyes. Proper rest should quell the likelihood of this possibility.
You should limit physical activity that is likely to raise your heart rate for at least one week after Mohs surgery. Also, try not to stoop or bend over if possible. Traveling right away is also discouraged, so if you came from far away to have the surgery, make plans to stay at a nearby hotel for a few days.
Facial stitches are usually removed within a week and stitches on other parts of the body are usually removed sometime within the first two weeks. While the incisions may look bumpy and pink at first, they will dramatically improve with time as the scars go through the normal maturation process over the first year. The redness and raised nature of the wound will improve up to a year after Mohs reconstruction.
Though both the surgery and the Mohs reconstruction are considered very safe procedures, as with all surgeries, there are some minor risks after the skin cancer reconstruction. Here are some of the risks in detail:
– You could develop hematomas, which are the blood from surrounding tissue bleeding into the wound after Mohs reconstruction
– The site of skin cancer removal may start to bleed
– Infections may develop, as can shooting pains and chronic itchiness
– Tenderness, pain, or temporary numbness can occur at the site where the skin cancer reconstruction took place
– Your scars may become thick or noticeable
Any makeup on the face, including products used specifically to camouflage the wound, can only be used once the area is fully sealed. This usually occurs approximately one to two weeks after the skin cancer reconstruction. This means it is perfectly fine to use cover-up on the incision lines while they are still in the process of healing, after sutures are removed.
Schedule your Skin Cancer Reconstruction Today
If you feel you need skin cancer reconstruction after undergoing cancer removal surgery in the greater Naples or Fort Myers areas, Dr. Holmes, or Dr. Agarwal of the Aesthetic Surgery Center will be sure to get you looking like new again once your carcinoma margins are cleared. Schedule an appointment today!
Related Procedures: Facelift, Rhinoplasty, Revision Rhinoplasty, The UpLift Facelift, Endoscopic Mid Facelift Surgery, Eyelid Surgery, Eyebrow Transplant, Chin & Cheek Surgery, Hair Transplant Surgery, Surgery of the Ears, Fat Transfer, Lip Augmentation, Endoscopic Eyebrow Lift, Scar Revision, Facial Trauma