Facial Skin Cancer Reconstruction

Nonmelanoma skin cancers (NMSC) are the most common type of cancer in the United States. Fortunately, most of us know the basics:

  1. Using sunscreen every day can go a long way in preventing skin cancer.
  2. Seeing a dermatologist for a yearly skin check can catch skin cancer in its early stages, when there’s a high cure rate and it’s easiest to treat.
  3. We should pay close attention to any areas on our face or body that are concerning and request a biopsy if we feel particularly worried about a changing or growing lesion.

But try as we may to stave it off, there’s still a possibility of developing skin cancer. And a diagnosis, especially on your face, can understandably cause a lot of anxiety. First, you want to know your chances for getting rid of the cancer. Then, you probably start wondering what long-term impact it will have on your appearance. How will the scars look? How big will the wound be? Fortunately, there are several effective treatment options to get rid of the cancer, reconstruct all aspects of the normal tissue, and minimize the scarring on the face.

Treating Facial Skin Cancer

While all surgery results in scars, facial plastic surgeons today are skilled in ensuring yours are thin, flat, soft and hidden in a pre-existing or normal site for a wrinkle or fold on your face, where they’re less visible.

The two most common methods of treatment for skin cancer and facial reconstruction are the Mohs procedure and wide local excision (WLE):

Mohs Procedure

The Mohs procedure (named after Fred Mohs, the inventor of the technique) is most commonly recommended to remove smaller areas of skin cancer, especially in cosmetically sensitive areas around the eyes, lips or nose. Not only does this technique have a high cure rate, it also allows you to keep as much healthy skin as possible. During Mohs surgery, a specially trained surgeon removes the visible skin cancer. Then they remove a thin layer of skin near the wound and examine it under a microscope to look for cancer cells. If cancer cells are found, they remove another thin layer of skin. The process is repeated until no more cancer cells are found. This means that you can be sure the cancer is removed during this one procedure.

Mohs surgery is typically performed as an in-office procedure using local anesthetic to numb the area. However, in cases where more extensive reconstruction is needed, it may be performed in a hospital using general anesthesia. Sometimes, the wound can be left to heal on its own and other times medical intervention is needed. Options to close facial wounds include skin grafts, rearrangement of tissue around the wound, or creating other local “flaps” of tissue to move into the wound.

Wide Local Excision

The other popular option for removing skin cancer on the face is a wide local excision. Your surgeon will remove the skin cancer lesion along with about ¼’’ to ½” of normal appearing tissue. The removed tissue will then be sent to a pathologist to make sure the cancer has been fully removed. The downside to this process is that if further cancer cells are found, you’d need to undergo additional procedures to remove the extra tissue later, retest and then reconstruct.

Depending on the case, this procedure may be done in-office using a local anesthesia or in the hospital using general anesthetic. Your wound can be closed using any number of techniques, including stitches and skin grafts. Once it’s confirmed that all of the cancer has been removed, reconstruction surgery can begin.

Emory Aesthetic Center

The Emory Aesthetic Center offers facial plastic surgeons experienced in facial skin cancer reconstruction techniques. During consultations we discuss the particular lesion that needs to be removed, the options for reconstruction, and even drawing the types of scars you may be able to expect. Knowing what to expect can provide peace-of-mind going into surgery.

About Dr. Sethna

Anita Sethna, MD, FACS, is double board-certified in Head and Neck Surgery and Facial Plastic and Reconstructive Surgery since 2010. She is also an Assistant Professor of Otolaryngology, Head and Neck Surgery at Emory University School of Medicine where she has taught since 2011. Dr. Sethna is the recipient of the AOA Research Award, and she is an accomplished expert in her primary areas of interest: rhinoplasty and injectables.



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