Mohs Micrographic Surgery (MMS) is one of the most successful procedures done at the laser center of NYC for removal of skin cancer with precision. Although this surgery helps in complete removal of tumor, it often leaves a scar. It can be emotionally upsetting when a scar is left in a prominent area especially when it affects the nose, lips or tissue around the eyes. However, an experienced and well-trained dermatologic surgeon like Dr Shelton, is able to restore a patient’s face to a healthy and natural appearance through a successful Mohs reconstruction in NYC, using his excellent knowledge in anatomy.
Mohs surgery procedure:
Dr Shelton first removes the skin cancer through Mohs surgery with maximum preservation of normal surrounding tissues by using real-time microscopic evaluation of the removed cancer. Watch the procedure in the following video:
He performs reconstruction in most patients on the same day after Mohs surgery. However, depending on each patient’s wound, the reconstruction procedure may need a skin graft, flap of skin, stitching or a surgical closure. Dr Shelton takes his patient’s appearance and time into consideration. Therefore, he considers many alternatives before closing a wound.
In the case of below patient, Dr Shelton performed a partial closure of the wound. Since the wound involved both cheek and nose, he didn’t want to patch it with a skin graft. He broke the defect into two components; One on the cheek and the rest was part of the nose. Dr Shelton closed up the cheek wound until the normal boundary line between the cheek and nose. The nose defect was allowed to heal on its own. He obviated the need to do another surgery of a skin graft from another area which would have looked out of place.
Natural Healing after Mohs Reconstruction: Below images show another nasal Mohs surgery where Dr Shelton let the defect heal on its own without a flap or a graft. It shows what the human body can do on its own sometimes:
Dr Shelton uses a vast array of techniques when it comes to Mohs Reconstruction in New York City, depending on the size and locations of the defect. Among various methods of performing skin reconstructions, some situations may need a skin graft, and in some others, a skin flap is done where a tissue is borrowed from an adjacent area to cover the defect.
Flap: In this procedure, Dr Shelton uses available skin on the nose to close the wound. He will recommend this reconstructive method if the wound is small and can be covered by stretching the nasal skin to close the incision.
Skin graft: A skin graft is done if the wound is too large to be covered with a local flap. The surgeon needs to find skin from elsewhere on patient’s body and he will identify the best area for the skin graft.
Because of these factors, Mohs surgery is performed in an individualized manner, until the defect is evaluated. Dr Shelton takes all attempts to minimize the scar visibility as much as possible.
Refer article at https://thenyac.com/mohs-micrographic-surgery-and-reconstruction to learn the factors which Dr Shelton considers when performing a Mohs reconstruction surgery.
The length of a reconstructive surgery ranges from 30 minutes to a couple of hours; however, it may depend on the extent of the post-Mohs wound or the required reconstruction.
Dr Shelton gives clear instructions to his patients on taking care of the wound depending on the nature of its closure.