What Type of Repair Is Used After Mohs Surgery According to Size of Defect?

What different forms of reconstructive surgery are performed for different size defects after mohs surgery? I have a BCC on my nose and will not know the ultimate size until the procedure is done, leaving little time to absorb the info and make a decision on type of repair. If the final defect is 1.5 cm or less, what procedure, if the defect is greater than 1.5 cm, what procedure? Which procedure leaves one with the least amount of consequential scarring? Forehead Flap leaves large scar extendin

Doctor Answers 5

How can i fix my nose after Mohs'

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This is an impossible question to answer as it is based on: precise location, size, depth, and prior history of surgery or radiation.  I recommend seeking a consultation to discuss just that--"what are my options".  There are almost always more than one, and even in the consultation it is impossible to predict how extensive the tumor will be and the plan may change. I usually prefer flaps over grafts, with some exceptions.     p 

How to repair the skin after Mohs surgery

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This is an excellent question, without a simple answer. Reconstruction after Mohs surgery depends a a number of factors: the size of the defect, the location of the surgery, the surrounding skin, the vicinity to other anatomic structures (ex. nose, eyes, lips) and others. As well a variety of techniques can be used to repair the skin including letting it heal be itself (A.K.A. secondary intention healing), a side to side or linear closure, a skin flap, and a skin graft. Mohs surgeons receive extensive training in reconstructive surgery, and possess the skills and  and knowledge that will lead to the best outcome, both from a cosmetic and functional standpoint. Make sure you discuss your concerns with your Mohs surgeon. They can lead you step by step through this process, to ensure you understand the the specifics of your surgery and receive the optimal outcome. I am often surprised how many patients come to my clinic claiming they will have a skin graft or skin flap. In the end, the patients are usually surprised with the reconstructive method chosen and how minimal the scarring appears after the recover.

Adam J. Mamelak, MD
Austin Dermatologic Surgeon

Recon after Mohs

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There are actual an infinite number of reconstructions since not only are there numerous techniques but every person is different and each body part is different.  In order to perform a simple reconstruction of the nose (actually a very complicated area), plastic surgeons need to perform thousands of surgeries over many years of intense surgical training. Do yourself a favor and have your reconstruction performed by a board certified PLASTIC AND RECONSTRUCTIVE surgeon.

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MOHS surgery designed to maximize cure, minimize scar

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The repairs done post MOHS surgery are determined by the size of a defect and the location on the body. Defects regardless of where they are located on the body should be closed in the best aesthetic manner possible to ensure the natural contours are correct and will not cause the patient any discomfort.  There are several types of closures that are commonly used by trained cosmetic dermatologists to minimize scarring which include: grafts, flaps and more. I recommend having any MOHS needed done by a MOHS surgeon who has been adequately versed in cosmetic repairs or a surgeon who will refer you to a properly trained MOHS surgeon. MOHS was developed to “maximize cure rate and minimize scarring” and should be held up to that standard.

Timothy Jochen, MD
Palm Springs Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Bcc on nose

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This is a good question, but as you can guess when writing it, there are no right answers and there are multple defects, locations, sizes and closures. If you go to a board certified Mohs surgeon, you will not only get the best type of surgery for the BCC of the nose,  they most likely  will be able to close it in the best possible way .

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.