Mohs Surgery - Scars

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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
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See what others are saying

Comment from: Jackie, 55-64 Female (Patient) Published: August 03

This is week 10 after having Mohs procedure done. The doctor left me with an open wound on my back, about a half inch deep and about a 3 inch diameter. I was told leaving the wound open was better than having it sutured. Wrong! Sutures would have been removed in 10 days or so. I still have about a one inch open wound and the pain and drainage continue. All of this for a small basal cell carcinoma. Before anyone even thinks of letting a doctor do this to them, look for an alternative procedure.

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Comment from: Sharon, 55-64 Female (Patient) Published: December 24

I recently had Mohs surgery for a very tiny basal cell carcinoma. Even during the procedure, which only needed two passes, the physician's assistant told me the cancer wasn't at all wide. However, they sent me home for two hours after the second pass because the office was closing for lunch and the surgeon didn't have time to close the wound until afterwards. When I came back, he barely re-numbed the skin, hastily cut away to make an oval, and stitched a huge 1 1/2 inch line down the side of my face. The upper corner is all lumpy and twisted. This is for a barely 1/8 inch non-life threatening superficial spot on my face. I don't go out unless I have huge sunglasses or a ton of makeup. My husband is grossed out by the hideous scar. I wish I were dead.

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