Forehead scars are better after reconstruction

Vincent N. Zubowicz, MD answers: How to repair Mohs surgery wound?

I had Mohs surgery on 8/14 to remove a basal cell cancer from my forehead. The wound is now open and covered and I'm weighing my options for repair. It's about the size of a silver dollar. It does seem to be closing/shrinking from all sides, albeit ever so slowly.

What are the advantages/disadvantages of waiting for it to continue to close before doing a skin graft or skin flap? Thanks!


Vincent N. Zubowicz, MD
2 months ago

Most wounds of the body (including Moh's) will heal by themselves--referred to as healing by "secondary intention". The problems with this is that it may take a long time to close completely and usually, but not always, the scar is worse than if a well-executed surgical closure was performed.

The forehead usually yields very good scars with reconstruction. The surgeon has to plan the operation so that the eyebrows are not asymmetric and the end of the reconstruction and that the scars are properly placed. This can often be done with local anesthesia if cost is an issue. Sutures are out in about a week. The scars fade away over a several months.

I would have opted for closure if I were you, presuming my appreciation of your wound is accurate based on the description.

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