MOHS – Facial SKin Reconstruction

Facial Skin Reconstruction (MOHS) Portland Oregon

If you’re contemplating, or have already undergone a procedure with a dermatologic (MOHS) surgeon to remove a tumor from your nose, face, scalp, ear, or neck, you’ve already completed the vital first step in treating skin cancer.

Following the removal of the neoplasm, you may be left with a large and unattractive skin defect. Crucial structures like the cartilage of your cheek, ear, nose’s outer skin, inner lining of the nasal cavity, or eyelid tissue may have also been removed.

A technique known as MOHS micrographic surgery, performed by a Dermatologic surgeon, ensures that the tumor doesn’t spread beyond its visible edges. Should it spread, the surgeon will continue removing tissue until no microscopic cancer cells are detected. This approach ensures the complete removal of the cancer while sparing as much normal tissue as possible around vital structures like the ear, mouth, nose, and eyelid.

The second component of treatment involves reconstructing the resultant wound. As facial plastic and reconstructive surgeons, our goal is to mend the skin defect in a manner that minimally impacts its appearance once fully healed while retaining the functionality of your facial features. The aesthetic reconstruction can be carried out on the same day, or up to a week after the tumor’s removal, either under local anesthesia, with or without sedation or a general anesthetic. It is advisable to discuss your preference for anesthesia with your surgeon.

Options for reconstructive procedures vary when it comes to repairing nasal, facial, and ear defects after MOHS surgery. For instance, smaller defects in certain facial areas might not require surgery and can heal naturally, although this is not advised for the scalp, nose, mouth, ear, or eyelid areas due to potential disfigurement, scarring, and functional issues.

Another option is to stitch together the wound’s edges, transforming a circular wound into a linear scar. It is achieved by manipulating the surrounding skin and then binding the skin with layers of sutures. This non-invasive approach may cause distortion to normal structures and can result in a scar that is twice the diameter of the initial wound, which can be more noticeable.

Skin grafts, either partial or full thickness, serve as another option, especially suitable for smaller areas of the nose or when there isn’t sufficient local tissue available. The donor sites could be the skin in front of the ear, clavicle, or thigh. Skin grafts may not blend perfectly with the surrounding skin in color or thickness and might require extended wound care.

One of the most effective reconstructive options is the utilization of local tissue similar in color and thickness. A small skin flap remains connected to the adjacent tissue and is transposed onto the reconstruction area. This approach might require a second-stage procedure 3-4 weeks post initial reconstruction to separate the pedicle and restore normal anatomy. Additional contouring may occasionally be necessary.

In most cases, complications are rare because the skin in the face, nose, scalp, and neck have robust blood supply. However, ear structures typically have less blood supply, which may lead to prolonged healing. Abandoning the use of any nicotine products and certain blood thinners, such as aspirin and Coumadin, is highly recommended during the surgery period as it can enhance wound healing and minimize the risk of bleeding, bruising, or hematoma formation. Despite using best practices to prevent or minimize scarring, they might still occur. Careful dressing and silicone gel or tape may help improve long0term scar appearance. It may take up to 12 months for the scar to fully mature and heal, during which further procedures might be necessary to manage unsightly scars.

The Process of Facial Skin Reconstruction

Facial Skin Reconstruction using the MOHS treatment method is a multi-step process that involves careful planning, precise surgical techniques, and attentive aftercare. Let’s take a closer look at each stage:
1. Initial Consultation

This is where you’ll meet with your dermatologist or plastic surgeon to discuss your facial skin concerns and assess whether Facial Skin Reconstruction is right for you. You’ll learn about the process, potential outcomes, and any risks involved. It’s important to ask any questions you may have and provide your surgeon with your medical history.
2. Pre-Operative Evaluation

Before the surgical procedure, your surgeon will perform a comprehensive evaluation to determine the extent of the skin damage, and plan the reconstructive procedure. Photography, digital imaging, and skin surface marking are some of the tools that may be used during this process.
3. Surgical Procedure

The MOHS technique involves removing the cancerous tissue layer by layer until the surgeon reaches healthy skin tissue. This method can take several hours, but it ensures that all of the cancerous tissue is removed while preserving as much healthy tissue as possible. Once the cancerous tissue is removed, the reconstructive process can begin.
4. Reconstructive Process

This process involves rebuilding the skin and soft tissue in the affected area. The type of reconstruction used depends on the extent of the skin damage and its location. Techniques like skin grafting, skin flaps, and primary closure may be used. The goal is to restore the appearance and function of the affected area.
5. Post-Operative Care

After the procedure, your surgeon will provide instructions on how to care for the treated area as it heals. You will need to keep the area clean and dry, avoid strenuous activities, and follow all instructions for medication, wound care, and any other postoperative treatment. Follow-up appointments are essential to monitor the healing process, evaluate the outcome, and adjust the treatment plan, if needed.

Understanding the process of Facial Skin Reconstruction using the MOHS treatment method is essential in making an informed decision about this treatment. Trusting a professional and experienced surgeon is paramount in ensuring successful outcomes and a speedy recovery process.

Outcomes and Benefits of Facial Skin Reconstruction

Facial Skin Reconstruction using the MOHS treatment method can provide remarkable benefits and outcomes that can positively impact your life in various ways.
Improved Facial Symmetry

One of the benefits of Facial Skin Reconstruction is that it can improve facial symmetry. If you have skin cancer or a facial injury, the affected area may look asymmetrical or unbalanced. Facial Skin Reconstruction can help restore harmony to your face by rebuilding the damaged areas, making your appearance more natural and healthy-looking.
Smooth and Even Skin Texture

Another benefit of the MOHS treatment method is that it helps to create a smooth and even skin texture. Facial skin damage, whether caused by an injury or surgery, can leave scars that affect your skin’s texture and tone. By using the MOHS technique, the surgeon can reconstruct the damaged skin area to restore the texture, making it smoother and more even.
Increased Self-Confidence

Facial Skin Reconstruction can also increase your self-confidence by improving your appearance. When you have visible skin damage, it can make you feel self-conscious and affect your self-esteem. By undergoing surgery to correct the damage, you can regain your confidence and feel better about yourself.
Effective Removal of Skin Cancer

If you have skin cancer, Facial Skin Reconstruction using the MOHS technique can effectively remove the cancerous cells while minimizing the impact on healthy tissue. By removing all cancerous cells, the treatment can help prevent skin cancer from recurring, improving your overall health and well-being.
Speedy Recovery Time

With the MOHS treatment method, the surgery is precise and efficient, leading to a faster recovery time. This means that you can resume your daily activities sooner after surgery. Additionally, the technique minimizes scarring, resulting in a less noticeable scar that can further boost your confidence.

Facial Skin Reconstruction FAQ

Facial Skin Reconstruction is a treatment method that aims to restore and improve the appearance of the facial skin. It involves using the MOHS technique to remove cancerous or damaged skin layers and reconstructing them for a more natural and aesthetically pleasing outcome.

How can Facial Skin Reconstruction benefit me?
Facial Skin Reconstruction offers several benefits, including improved facial symmetry, texture, and overall appearance. It can also help enhance self-confidence and restore normal functioning of the affected areas.
What does the process of Facial Skin Reconstruction involve?

The process of Facial Skin Reconstruction typically starts with a consultation to assess your specific needs and goals. The MOHS technique is then used to remove the affected skin layers, followed by reconstructive procedures to restore the appearance of the treated area. Post-operative care and follow-up appointments are also part of the process.

Is Facial Skin Reconstruction a painful procedure?
Facial Skin Reconstruction is performed under local anesthesia, which numbs the treated area and minimizes discomfort during the procedure. You may experience some pain or discomfort after the treatment, but medication can be prescribed to manage any discomfort.
Are there any risks or complications associated with Facial Skin Reconstruction?

As with any surgical procedure, Facial Skin Reconstruction carries some risks. These can include infection, bleeding, scarring, or adverse reactions to anesthesia. However, with an experienced surgeon and proper post-operative care, the risks can be minimized.

How long is the recovery period after Facial Skin Reconstruction?
The recovery period can vary depending on the extent of the treatment and individual healing capacity. Generally, it can take a few weeks to several months for the treated area to fully heal. Your surgeon will provide specific post-operative instructions and guidelines for a smooth recovery.

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