Treatment of Melanoma on Face
Best option to cure the lentigo maligna (melanoma in situ) on your face is Mohs surgery, usually performed with immunostains (to help "light up" the melanocytes when viewed under the microscope). In my opinion your best option for Mohs is to see a fellowship-trained Mohs surgeon who is a member of the American College of Mohs Surgery. Best one of these to see is one who has a lot of experience treating lentigo malignas on the face. In my opinion best option for reconstruction is whoever you feel will give you the best cosmetic result, whether that would be the Mohs surgeon or plastic surgeon with facial reconstruction experience. Good luck.
MOHs is by far the best treatment option in this case, as the recurrence rates and clearance will always be better than Standard excision. However there are other options such as immunotherapy with imiquimod. Seek a specialist who does MOHS but also is competent in reconstructive surgery and general dermatology. We would gladly see you in our clinic. I wish you the best. Regardless, there will be a scar that will need to be intricately taken into consideration and finding the right physician in this situation is imperative. Dr Emer.
Treating a melanoma or atypical pigmented lesion on the face
Treating an early melanoma or atypical pigmented lesion on the face can be done with a high cure rate and preserving normal tissue using the Mohs or slow Mohs surgical technique. If the melanoma is deeply invasive, then you may or may not need additional workup. I would recommend seeing a fellowship trained Mohs surgeon who belongs to the American College of Mohs Surgery (ACMS). Every melanoma is unique and this advice is generic. Specific details about your care should be discussed with your official physicians.