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Should I Request a Plastic Surgeon for Mohs Reconstruction?

asked 1 year ago by Hopeful in Auburn in Auburn WA
Latest answer by Christopher Zoumalan, MD
Question viewed 1,556 times
Tags: between eyebrows, basal cell carcinoma, plastic surgeon, reconstructive

My Mohs Surgeon does his own reconstruction. Should I request a plastic surgeon? I have Basel Cell Carcinoma between my eye and my nose, and I have yet to have my pre-surgery consultation with the surgeon.

14 answers to Should I Request a Plastic Surgeon for Mohs Reconstruction?

Should I request a Plastic Surgeon do the repair after Mohs surgery

The correct answer is you should pick the person who you think is going to give you the best result. As mentioned by many others a well-trained and experienced member of the American College of Mohs Surgery should be able to perform just about any necessary reconstruction, but if you think that a plastic surgeon is going to give you a better result, pick a plastic surgeon. That's not to say the plastic surgeon will provide the smallest scar or the best cosmetic result. Both Mohs... more

Andrew Kaufman, MD
Los Angeles Dermatologic Surgeon

www.dermatology-center.com

Mohs reconstruction options

Following Mohs surgery nearly all of the reconstructions are performed by your Mohs surgeon assuming that they are fellowship trained and a member of the Amercian College of Mohs Surgery. The key word is College and not Society as there are several gorups out there with similar names. Only members of the Mohs College have been required to spend an additional year after board-certification performing over 500 Mohs cases, becoming experts in complex reconstruction of... more

Shawn Allen, MD
Boulder Dermatologist

Your Mohs surgeon can help you decide on the optimal reconstruction after Mohs surgery

In the US, the majority of reconstructions done after Mohs removal of a skin cancer in this country are done by the Mohs surgeon, typically immediately after the skin cancer removal. Fellowship-trained Mohs surgeons are usually dermatologists who have done a full year of training after residency devoted primarily and specifically to Mohs surgery and the reconstructive techniques necessary to repair the defects. Mohs surgeons, plastic surgeons and other specialists (facial plastic... more

Daniel Berg, MD
Seattle Dermatologic Surgeon

Mohs

Consider that a plastic surgeon has a minimum of 6 years of surgical training. Now consider that a dermatologist has zero years of formal surgical training.

Samer W. Cabbabe, MD
Saint Louis Plastic Surgeon

Eyelid Reconstruction after Mohs Surgery for Skin Cancer

Fellowship-trainined MOHS surgeons are dermatologists who have received additional training in treating skin cancers. Most of them are also very well trained in repairing defects in most parts of the face. However, eyelid skin cancers are challenging to repair especially when they involve the lid margin, eyelashes, and the tear duct drainage system. You may want to consult with an Oculoplastic Surgeon to help in the reconstruction of the defect after the MOHS procedure has been... more

Christopher Zoumalan, MD
Beverly Hills Oculoplastic Surgeon

Repair of MOHS around the eyelid

Reconstruction of the eyelid after MOHs require techniques that reduce the possibility of lid malpositions such as ectropions or eyelid asymmetry. If the lesion is small and there is excess skin, closure of the wound without adjacent tension will likely not result in lid malposition. However, if there is exisiting laxityof the lower eyelid and if the closure imparts tension such that the lid moves away from the eye, reconstruction using free skin grafts or myocutaneous flaps might be... more

John Pak, MD, PhD
Chicago Oculoplastic Surgeon

Reconstruction After Mohs Surgery

In general, an individual fellowship trained in Mohs surgery is more than capable of treating your tumor and reconstructing the defect. I work with a number of fellowship trained Mohs Surgeons in my area who are excellent what they do, but sometimes feel it is appropriate to refer patients to me for a variety of reasons. These reasons include complex nasal, lip, ear, or scalp defects which are very large in size or in which important structural elements such as cartilage or nasal... more

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon

Reconstruction following MOHS surgery

Reconstruction following MOHS surgery can be adequately repaired by well trained MOHS dermatologic surgeon. However, in the particular area that your skin cancer is located in - between the eye and nose, the skin cancer may involve the tear drainage system or other periocular structures. In this case, you may want to consider an oculoplastic surgeon who is well versed in the tear drainage system and periocular structures to repair your defect. Appropriate reconstruction... more

Keshini Parbhu, MD
Orlando Oculoplastic Surgeon

Reconstructions by a fellowship-trained Mohs surgeon

The answer lies with the training in reconstructive techniques that your Mohs surgeon received during fellowship and experience acquired while in practice. As a Mohs surgeon, I routinely perform complex reconstructions such as flaps and grafts on patients undergoing Mohs micrographic surgery. I often find that my annual volume of highly complex reconstructions such as forehead flaps exceeds those performed by quiet a few of my colleagues in other surgical specialties. While plastic... more

Larisa Ravitskiy, MD
Columbus Dermatologist

Mohs surgery followed by plastic surgery

Your Mohs surgeon should be able to help you make this decision. A plastic surgeon is a reasonable option if your Mohs surgeon feels he or she will leave you with a noticeable scar.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon

www.palmbeachdermasurgery.com

Plastic surgeon or dermatologic Mohs surgeon can do reconstruction

Reconstruction after Mohs surgery is often performed extremely well by both plastic and dermatologic surgeons. Unfortunately not all plastic surgeons provide the same consistent good results and not all dermatologic Mohs surgeons provide the same consistent good results. Within any specialty there is a difference in the individual physician's innate abilities, interest and enthusiasm, experience, training and within this field of reconstruction, a different aesthetic sense. ... more

Ronald Shelton, MD
Manhattan Dermatologist

Mohs: Common Questions

The question you ask is a very good and perceptive one. After your reconstructive surgery there will be a scar - as there is in all surgery. However, the appearance of your final scar is ultimately the result of your physicians understanding of aesthetic subunits, reconstructive options, local anatomy, meticulous wound closure and operative experience. Often small lesions are closed in excellent fashion by my Mohs colleagues. When defects are larger or located in an anatomically tricky... more

James M. Ridgway, MD
Seattle Facial Plastic Surgeon

Moh's reconstruction

An experienced plastic surgeon is always a better choice for Moh's reconstruction in my opinion rather than the dermatologist who is performing the procedure who has learned a few tricks along the way but has never been trained in the full range of plastic surgery. The problem is coordinating schedules and because of this and because they can also bill for the reconstruction many derms choose to do it themselves. But the best plan is combined. Remember that the... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Who does the closure

This depends on the final defect, location and experience of the surgeon. In most cases Mohs surgeons repairs are equal to plastic closures, and save money as well as risks associated with general anesthesia. Dr. Malouf