What is Facial Skin Cancer Reconstruction?
Facial skin cancer reconstruction in non-eyelid areas are typically performed by Mohs surgeons. Mohs surgeons are dermatologists who specialize in Mohs surgery, the current technique with the highest success of removing skin cancers completely. Given the delicate and complex anatomy, skin cancers on or near the eyelids may be referred to oculoplastic surgeons. Typically, either your dermatologist or oculoplastic surgeon will obtain a biopsy to first identify whether a suspicious skin lesion is indeed skin cancer, such as basal cell or squamous cell carcinoma. If your biopsy reveals a skin cancer, the next step is to remove the lesion completely with a Mohs surgeon. During Mohs, the skin lesion is removed and examined under a microscope. If there is residual cancer, the Mohs surgeon repeats the process, until there is no detectable skin cancer. After Mohs is completed, the final step is reconstruction.
The Surgery :
Reconstruction is typically either performed on the same day as Mohs surgery or the following day. There are a great variety of ways that eyelids can be reconstructed, and the specific reconstruction plan won’t be determined until after the skin cancer is removed following Mohs surgery. Once the final defect size and location is known, then your surgeon will use their expertise to form a plan to restore both function and form. This may involve reapproximating adjacent tissue, rotating adjacent tissue, borrowing eyelid tissue from the same or even opposite side, and even may require a skin graft (typically from near the ear or inner arm). The surgery is usually performed in an outpatient (non-hospital) setting under light anesthesia consisting of IV sedation and local medication injected at the surgical site. Patients are able to go home the same day of the procedure.
What to Expect After Surgery :
Typically, you will go home with a patch over the area for the first few days up to 1 week. Bruising, swelling is typical after eyelid surgery and peaks in the first post-operative week. We recommend remaining home to recover for approximately one week. Thereafter, most patients can comfortably return to work. During the recovery period, heavy exertion and makeup use is avoided. Sutures may be removed at the first postoperative visit at one week.