Reconstruction after skin cancer surgery
Although the main aim of skin cancer surgery, and especially of Mohs surgery, is to remove the tumour completely, preserving anatomy, function and facial appearance must always be part of the decision-making.
It is understandable to be concerned about the scar, but in certain areas of the face reconstruction goes far beyond achieving a barely visible scar. Maintaining facial symmetry, expression, the structure of the nose or the function of the eyelids can be as important as closing the wound itself.
Experience and a careful study of the anatomy and of each patient's individual clinical circumstances and habits are essential in planning skin cancer surgery and are key to successful reconstruction.
RECONSTRUCTION
Individual planning
After a skin cancer has been removed, reconstruction is not just a matter of closing the surgical defect.
Reconstruction must therefore be planned individually from the start of surgery, taking into account not only the size of the defect but also its location, the structures involved and the characteristics of each patient.
The aim is to achieve appropriate oncological control and, at the same time, restore the anatomy and function of the treated area as well as possible, minimising the impact of surgery on the patient's daily life.
CLINICAL APPLICATION
How is a surgical defect reconstructed?
The reconstructive technique is chosen according to the size, depth and location of the defect, as well as the mobility and characteristics of the nearby tissues.
Direct closure
When the defect is small and the edges can be brought together without excessive tension, the wound can be closed directly.
It is the simplest option, provided it allows the anatomy and function of the area to be properly preserved.
Flaps
A flap involves moving skin and tissue next to the defect while keeping their own blood supply.
It is particularly useful in complex areas of the face, where it allows reconstruction with tissue of similar characteristics and better respects anatomical contours.
Grafts
A graft involves closing the defect with skin taken from another part of the body.
Grafts are reserved for situations in which reconstruction by direct closure or a flap is not possible because of the size, location or characteristics of the defect.
ANATOMY AND FUNCTION
Anatomical areas of particular reconstructive importance
Some locations require particularly careful planning because small changes in their anatomy can have significant functional and aesthetic consequences.
The nose, eyelids, lips, ears and scalp have their own characteristics that influence the choice of reconstructive technique.
On the nose it is important to preserve its contour and structure; on the eyelids, to maintain proper protection and function of the eye; on the lips, to preserve mobility and oral competence; and on the ear or scalp, to respect their anatomy and the particular characteristics of the tissues.
For high-risk tumours in these areas, Mohs surgery can be particularly useful, as it allows microscopic control of the margins while preserving as much healthy tissue as possible. Once the tumour has been completely removed, the reconstruction is planned individually around the resulting surgical defect.
Specialist consultation
Dermatologist · Dr. David Moreno