When Mohs and Plastic Surgeons Work Together

Posted January 29, 2018 in Mohs

20 percent of all Americans will develop skin cancer during their lifetime. Unfortunately, removing cancerous tissue from the skin can leave unsightly scarring, especially if the cancer extends over a wide surface area. Because many skin cancers develop on the face, scalp, hands, and other sun-exposed areas, patients may feel concerned about how they will look after their treatment. When your Mohs surgeon and plastic surgeon work together, you can receive life-saving cancer treatments and face-saving plastic surgery to maintain your appearance while becoming skin cancer free.

Mohs Surgery for Skin Cancer

For basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs), which are the two most common types of skin cancer, Mohs micrographic surgery is the gold standard treatment. In Mohs surgery, the dermatologic surgeon removes a layer of tissue and examines it under a microscope on site. If there are any remaining cancer cells, the surgeon can see exactly where they are and remove further layers of tissue until no cancer cells are left. Mohs surgery allows the surgeon to spare more healthy tissue while knowing with confidence that all cancer cells have been excised. The main indication for Mohs surgery is in the face, particularly around the eyes, ears, and nose where deep tumor invasion can be rapid due to a lack of subcutaneous tissue. By minimizing the excised tissue, Mohs minimizes the size of the defect that needs to be reconstructed. This makes reconstruction easier and scarring less. Mohs is used less often on the torso or limbs where there is redundant tissue and scars are easier to hide.

Even though Mohs surgery minimizes the amount of excised tissue, reconstruction still has to be performed with skill in order to get a good cosmetic result. Fortunately, Plastic Surgeon Dr. Brian Boyd shares an office with Mohs Surgeon Dr. Howard Fein and is available for the immediate reconstruction of Mohs patients. Rather than waiting a day or two and traveling to a different office for reconstructive surgery after Mohs, patients can experience ‘one-stop shopping’ and get immediate assistance from Dr. Boyd directly after their cancer is removed. Patients who need Mohs treatment for skin cancer can combine the knowledge and experience of both medical professionals to eliminate their cancer and achieve the best possible aesthetic appearance.

Mohs Surgery With Plastic Surgery

Immediate plastic surgical reconstruction after Mohs surgery will usually produce the best cosmetic results. When possible, Dr. Boyd hides any surgical incisions in natural skin folds so they are inconspicuous. Where needed, he performs local tissue rearrangement using a skin flap or graft to restore the appearance of the treated area. The most important point is that Dr. Boyd works closely with Dr. Fein, and together they tailor a specific treatment plan to the individual patient.

For more serious cases in which the tumor has attained a significant size, excising the cancerous tissue can require the removal of a section of the nose, lip, eyelid, or other facial structure. Because Dr. Boyd has 30 years of experience and is trained in microvascular surgery and other major reconstructive techniques, he can reconstruct these facial features with complete confidence. In his hands, reconstruction of any facial features after Mohs surgery will minimize scarring, establish a normal appearance, and maximize the function of the affected part.