I had a skin graft after Mohs. The graft extended down into my upper lip. The result is my lip line (from the center extending about 3/4 of an inch towards the left corner of the lip) is gone and the area below where a lip line would be is flat until it reaches the scar where the graft was attached. Can this be fixed. Plastic surgery or injectible filler? Who is the best doctor in NYC for this kind of surgery? Cost is no object.
Can Surgery Repair my Lip? Had a Skin Graft After Mohs
Doctor Answers (4)
I have never heard of needing to do a skin graft after lip skin cancer excision. I usually repair these with lip flaps or local flaps. Please call the office and schedule an appointment for evaluation.
Mohs, Grafts and Lip Reconstruction
Once Mohs surgical excision is performed most Mohs surgeons then place a skin graft as a temporary fix to get the wound healed and a consultation can be obtained from a Plastic Surgeon. This should be uniformly true for cancers in delicate and complex areas of the face such a the nose or lips. Cosmetic reconstruction of the lip is complicated and usually involves complete removal fo the skin graft and transposition of available adjacent cheek tissue to replace the entire quadrant of the lip while trying to match the opposite normal side of the lip. There have been textbooks written on the subject but very few non-Plastic Surgeons are exprerienced in these operations.
Lip line can often be improved with lip advancement
Based on your description it sounds like excision of some of the skin graft with advancement of the red part of the lip would give you a nice result. You would need to share photos to know for sure. I don't use skin grafts on any part of the lip for the exact reasons that you note. There is not a great color or texture match with the lip. Seek a board certified Facial Plastic Surgeon or Plastic Surgeon to determine what options are best suited to your specific concerns. However, based on your description this can likely be improved.
Thank you for your question.
Stephen Weber MD, FACS
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Repair of Lips after Graft and Mohs Surgery
I think your best option is to return to the doctor who performed the Mohs surgery and tell him or her that you're not happy with the cosmetic result and want to see the best doctor to improve the final result. I would not return to the doctor who performed the repair as I would assume that they did their best by performing the skin graft in this area. Also, it takes 6-12 months to get the final cosmetic result from any surgery, but start by talking to the doctor who removed your skin cancer and referred you to the other surgeon.
Now, most importantly, you had a skin cancer on your upper lip, and no matter what type of repair or who performs the repair, there will be a scar. It is possible that the result that you have is going to be the best result possible. It is impossible to give an informed opinion over the internet. The doctor needs to examine the area in person and discuss with you what can and cannot be done. Having said that, I'm sure there are a number of excellent surgeons in New York that can help you. Most likely a fellowship-trained Mohs micrographic surgeon or plastic surgeon will have the most experience and training to give you an informed opinion about your best options. Best of luck.