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Skin Cancer Surgery (Mohs) Reconstruction

According to the American Cancer Society, the number of skin cancer diagnoses have been on the rise and they estimate that 5 million people are treated for skin cancer each year. This makes skin cancers, such as Squamous Cell Carcinoma, Basal Cell Carcinoma and Melanoma, some of the most common forms of cancer in the U.S. 

What are Common Types of Skin Cancer?

Basal Cell Carcinoma and Squamous Cell Carcinoma

The treatment of these skin cancers is either surgical excision or Mohs chemosurgery. Mohs surgery is a procedure performed by a dermatologic surgeon to completely clear the tumor by carefully excising close margins of the tumor and examining this under the microscope until the tumor is completely cleared. This has been proven to improve cure rates over simple excision alone while making sure to remove as little tissue as possible. This technique is especially important within critical areas such as the ears, nose, eyes, face and neck.

Even if the resulting defect in the face is small, some patients prefer to have a plastic surgeon close this to ensure the best cosmetic result. In other instances, the defect is in a critical area to reconstruct or larger than anticipated and requires the expertise of a facial plastic surgeon to close this. Dr. Ezzat works with dermatologic surgeons to coordinate the Mohs surgery and the plastics closure so that treatment and closure occur in an expeditious fashion. 

Patient Examples

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Squamous cell carcinoma pre-surgery (left) and post-surgery (right)

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Squamous cell carcinoma pre-surgery (left) and post-surgery (right) 

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Basal cell carcinoma pre-surgery (left) and post-surgery (right)

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 Basal cell carcinoma pre-surgery (left) and post-surgery (right)

Melanoma of the Skin

Melanoma is a type of skin cancer that requires a more aggressive treatment regimen than Basal Cell or Squamous Cell Carcinoma. Because of the aggressive nature of melanoma, Mohs Chemosurgery is typically not done. Instead, surgical removal with wide margins (taking additional normal skin) is required. Having a surgeon with expertise in facial plastic surgery is especially critical in these cases where larger defects typically occur in sensitive areas such as the ears, nose and face.

Patient Example

Melanoma pre-surgery (left) and post-surgery (right) 

All complex cases are presented at our multi-disciplinary head and neck and multi-disciplinary skin oncology tumor boards to ensure that any additional therapies are coordinated as well. This ensures a focused, patient-tailored treatment plan that includes making sure the functional and cosmetic results are optimized.

Why go to a Facial Plastic (Reconstructive) Surgeon for Skin Cancer?

Equally as important as clearing the cancer, is restoring the head, face, and neck as close as possible to its pre-treatment state – both in form and function. A facial plastic surgeon specializes in cosmetic and reconstructive surgery within the head, face, and neck. In addition to completing an official surgical residency, facial plastic surgeons complete an advanced fellowship in facial plastic and reconstructive surgery and have passed a rigorous national written and oral exam. They must also present a number of cases they have performed in practice for review by a national board and only after successful completion of all of this, can they become board-certified in facial plastic and reconstructive surgery.

Selecting a board-certified specialist to reconstruct the face is an important step in obtaining the best possible results. Due to the intricate anatomy of the face and the important function it serves in one’s everyday activities, having a surgeon whose training and practice is solely dedicated to reconstructive surgery within the head, face, and neck is critically important.

Patients are involved in discussions surrounding their condition and options for providing the ideal reconstruction, and they are encouraged to ask questions and to share their thoughts and preferences.

"The difference in my appearance is subtle yet powerful in ways beyond the aesthetic."

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