Is It Okay for a PA to Do Facial Repair After Mohs?

Although I do not have a P.A. in my office, they certainly could do the sewing of a skin graft. P.A.s have been utilized by plastic surgeons to sew the skin after a facelift is done! Experience is a crucial component of the ability for a P.A. to peform excellent work, and the physician is responsible to supervise their work and is responsible for the outcome.

Defects after Mohs Micrographic Surgery are typically repaired with sutures which involve buried sutures that are meant to provide strength and hold wounds together and self-dissolving  followed by top epidermal sutures that are meant to line up wound edges evenly and should be removed 5-14 days depending on location. While some Physician Assistants or Nurse Practitioners may be well-trained and qualified to perform suturing, dermal/buried suturing particularly on the face and neck should be performed by a board-certified physician. The top epidermal sutures are more straight forward and mechanical and can be performed by Physician Assistant or Nurse Practitioner under supervision and discretion of a board-certified physician.

It is o.k. for a physician's assistant to do the repair after Mohs surgery,... but only if it's o.k. with you. Some physician's assistants probably do very good work, but I would agree with your comment that it's difficult to compare an MD with a PA. Everybody has preferences as to who should do the repair... plastic surgeon, dermatologist, facial plastic surgeon, etc. My own preference is that I would prefer that a fellowship-trained Mohs surgeon (i.e. from the ACMS) or a fellowship-trained plastic surgeon (i.e. ASPS) do my repair or fellowship-trained oculoplastic surgeon (if it involves the eyelid). So tell the doctor that you would prefer that he or she do the repair next time.