Mohs Surgery

  • Medical Author:
    Gary W. Cole, MD, FAAD

    Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Cancer 101: Cancer Explained

What is reconstruction? Will I have a scar after Mohs surgery?

Reconstruction is repairing or fixing the wound produced after removal of the malignant skin tumor. This procedure is not different than any treatment performed after any conventional surgical procedure performed on skin. Repairing or closing the wound may involve having your surgeon stitch the wound closed side by side. Sometimes an area may heal best by letting the wound heal by itself naturally without stitches. Additional reconstruction options include using a skin graft or moving a flap of skin. Shared decision-making is very important with this issue, and it can help if you are involved by reviewing how you prefer to repair the wound.

The main goal with Mohs surgery is to remove the skin cancer in its entirety. Once the cancer is removed, then your surgeon will look at options of how to best repair the wound producing the optimum cosmetic result. The goal of MMS is to clear skin cancer, achieve the smallest scar, and preserve the maximum amount of normal tissue. Since all MMS procedures produce scars it may be necessary to consider options like lasers, scar creams and gels, and cortisone injections depending on the healing process. However, do not expect these treatments to completely remove the scar.

In summary, there are two parts of the procedure. The first part is the removal of the entire tumor by cutting out and examining horizontal stained frozen sections of tissue. The second portion of the procedure is the repair of the wound. Depending on a variety of factors, the wound could be reconstructed by the physician who performed the original MMS procedure, by a second surgeon (plastic or ENT), or the wound could be allowed to heal on its own (secondary intention).

Intra-op wound
Picture of an intra-op wound
Sutured wound
Picture of a sutured wound
Healed post-op site
Picture of a healed post-op site
Medically Reviewed by a Doctor on 6/3/2016

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