A skin cancer diagnosis and all that follows can be scary and intimidating, especially if the cancer was found on your face. But there’s some comfort in having a clearer idea of what will happen next. So, I’m going to walk you through Mohs reconstruction surgery. Over the next three blog posts, I’ll explain what the surgery entails, what the healing process is like, physically and emotionally, and the different scar treatments that are available.
If you’ve been diagnosed with basal cell or squamous cell carcinoma, Mohs reconstruction surgery will most likely be presented by your dermatologist as a treatment option. In a nutshell, it’s a procedure where the skin cancer is scooped out.
You’ll probably be left with a hole where the carcinoma once was. Sometimes, it’ll close on its own with the help of some stiches. More often, there’s not enough skin on either side to enable that to happen. That’s where skin grafts and flaps enter the picture.
Comparing a flap and a skin graft
Several factors will be taken into consideration when making the decision between a flap or a skin graft, including the size of the skin cancer and the condition of the surrounding skin. Your board-certified dermatologist should discuss the pros and cons of each with you, and you should arrive at a decision together.
To help prepare you for that moment, let’s discuss how they work.
A flap is much like what it sounds like. A section of skin from around the area where your skin cancer was removed is used to reconstruct the affected area by either being slid, transposed, or rotated into the wound.
Flaps are typically the first option. But, if you’re on blood thinners, for example, doing a flap has a higher risk of complications. Or, depending on the location of the wound, there may not be enough extra skin nearby. In those instances, your dermatologist will recommend a skin graft.
The procedure entails taking skin from somewhere else on your body, like around your clavicle or behind an ear, and placing it into the wound. Where the graft is taken from will depend on the size of the wound and how well the skin matches the area from which the skin cancer was removed.
Perhaps the most significant contrast between the two is a flap has its own blood supply while a skin graft does not, which means the healing process is a little different. We’ll get into that in the next post. For now, rest assured that, given a little time, the skin graft’s blood vessels will connect to the vessels in the surrounding skin and the healing will begin.