Facial Reconstruction for Mohs Defect Repairs

Excerpt

Mohs micrographic surgery (MMS) represents a powerful technique to decrease morbidity when treating nonmelanoma skin cancers (NMSC), a highly prevalent malignancy in the US and other western populations. MMS utilizes surgical mapping and complete histological evaluation of tumor margins to excise high risk cutaneous basal cell carcinomas (BCC), squamous cell carcinomas (SCC), and certain cases of invasive melanoma. By correlating the histological results with a precise location on the surgical map, complete tumor removal is achievable while maximizing normal tissue preservation. This tissue preservation remains particularly important on the face to maximize functional and aesthetic outcomes. Nonetheless, there are instances when obtaining clear surgical margins results in significant post-excisional defects. This article provides an overview of facial reconstruction after MMS, with a focus on reconstructive principles for the forehead, nose, cheek, and perioral regions.