Typically eyelid defects created following Mohs cancer surgery are closed immediately or the next day. Very small defect can be allowed to heal on their own. However, when the defect involves the eyelid margin, or the tear sac area, or larger portions of the eyelid, the Mohs surgeon will generally arrange for the closure (reconstruction) to be performed by an oculoplastic surgeon. It is ideal if you can meet the oculoplastic surgeon before hand and know what the plan will be. If you open your mouth and ask for this, it is more likely that you will get this type of reconstruction. Sometimes the Mohs surgeon feels a lesion near the eyelid can be handled just by the Mohs surgeon and that is fine. However, sometimes the lesion proves to larger than anticipated and this can lead to the 6 PM urgent oculoplastic consultation. Regarding patching, small defects can be closed without patching the eye. When the defect involves the eyelid margin and you need to be reconstructed either later that same day or the next day, yes it is common to patch the eye. Because of the large variation in what may be needed, it is impossible to predict what you will need. If you are nervous about how the reconstruction will be handled, insist on meeting the oculoplastic surgeon ahead of the Mohs cancer surgery.