Mohs reconstruction is a substantial and rewarding part of our Austin practice. After a Mohs surgeon removes a skin cancer, the plastic surgeon’s job is to rebuild the resulting defect — often on a highly visible area like the face — in the most cosmetically acceptable way possible. Every defect is unique, which is where reconstructive skill and an artistic eye come together. And in most cases we can do it right in the office under local anesthesia, so patients avoid anesthesia recovery, nausea, and the associated risks.
What Is Mohs Surgery?
Mohs surgery (also called chemosurgery), developed in 1938 by Dr. Frederic Mohs, is a microscopically controlled technique for treating common skin cancers. Tissue is removed in stages, and each layer is examined for cancer cells before deciding whether more needs to come out. This provides complete margin control using frozen-section histology, allowing removal of the cancer with very narrow margins and a high cure rate — but it can leave an open wound that needs reconstruction.
What Is Mohs Reconstruction?
This is where the plastic surgeon comes in: taking what can be a frightening open area in a visible location and closing it beautifully by shifting adjacent, regional, or distant tissue to restore the area. Depending on the size and location, reconstruction may use direct closure, a skin graft, a local flap (nearby skin moved with its own blood supply), or a distant flap.
How We Coordinate Care
We work closely with local Austin Mohs surgeons to coordinate each patient’s care. Ideally we consult before the planned excision to review the likely reconstructive options, then see the patient immediately after the Mohs removal to photograph, measure, and plan. In the vast majority of cases we add a small amount of additional local anesthetic (much less uncomfortable than the first injection, since the area is already numb) and perform the reconstruction right then — usually in under an hour. For defects too large to close comfortably in the office, we re-dress the area and schedule the repair at an accredited surgery center.
The Bottom Line
Mohs reconstruction combines careful engineering with an artistic eye to restore form and appearance after skin cancer removal — most often in the office, under local anesthesia, with an easy recovery. If you have an upcoming Mohs excision, contact us to plan your reconstruction, and see our approach to safety.