Skin graft revision possible after MOHs, reconstruction? (Photo)

In Sept. 2015 I had MOHs for a BCC on my lower eyelid. After that, I had reconstruction with a skin graft taken from my upper eyelid. I am pleased with the color but not the texture. The graft is raised and looks like a lump under my eye. The surgeon who did he graft injected it with Kenalog twice afterwards, and then advised no further procedures. He felt anything else would give me a worse result, not better. I'm not happy with this. Any ideas?

Doctor Answers 1

Skin graft scar to the eyelid after Mohs for BCC skin cancer- what to do?

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  • When a graft heals, it can do a great job of filling the defect without pulling your lower lid down- so it is a reasonable choice with a wide defect
  • However, the color and texture match are somewhat less than ideal, and this is normal with grafts
  • Now that the swelling is all gone and things have softened you could have the scar revised. A plastic surgeon would have to examine you in person. But I would guess that with a skilled and experienced plastic surgeon, removing the graft at this point would work.  I would suggest closing the area in a straight line with local  skin thereby getting rid of the lumpy graft skin.  Some elevation of the skin below the graft would be needed to advance the skin upward to achieve a linear scar. 
  • In most cases, you would see nice improvement.  This would be my approach to your eyelid basal cell skin cancer reconstruction. And I have done thousands of basal cell wound closures. Find a local plastic surgeon who can see you in person and decide whether revision is a good idea, or whether leaving it alone is best. There are risks and benefits to each.
  • Good luck and thanks for your important question that will help others as well in a similar situation.

New York Plastic Surgeon
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