Recognized as one of “Boston’s Most Trusted Doctors” by Boston magazine, Richard A. Bartlett, M.D. is a board certified plastic surgeon in practice for over 30 years Dr. Bartlett is considered a “doctor’s doctor,” and is a favorite choice of New England medical professionals when referring family and friends for cosmetic and reconstructive plastic surgery in Boston, Massachusetts.
Cases of skin cancer are on the rise across the country. To remove certain skin cancers, including squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), dermatologic surgeons use a special technique known as Mohs micrographic surgery.
The technique allows your doctor to closely examine each layer of the skin to detect cancer cells. During the procedure, your dermatologist will remove the cancerous tissue one layer at a time.
The cancerous skin can be removed easily if it appears in small amounts. However, there are times when there is too much cancerous tissue located in sensitive areas that make it more difficult to remove. In such cases, reconstructive surgery is necessary.
Types of Reconstruction
After thoroughly evaluating your anatomy and associated health problems, your surgeon might recommend one of three primary reconstruction methods:
• Primary closure
• Local flap closure
• Skin graft closure
Primary Closure
This method is used if the defect is small. In this method, the wounds will either be allowed to heal on their own or will be closed with medical sutures.
Local Flap Closure
A primary closure isn’t ideal if the defect is large or located near an anatomical structure. In this situation, your surgeon will instead choose a local flap closure. He will rotate the local tissue adjacent to the wound in order to close up the defect.
If the defect is on the nose, cartilage is taken from the ear to restore functional and structural integrity. Some of the most commonly performed flaps include the nasolabial flap, paramedian forehead flap, advancement/rotational flaps, and the bilobed flap.
Skin Graft Closure
A skin graft is recommended for shallow defects. This involves borrowing adjacent skin from another area of your body to transplant into the defective area. The transplanted skin is then secured with sutures, and the donor site is closed primarily. This ensures the best possible repair.
Post-Operative Instructions
• Clean the crusts off with hydrogen peroxide and a Q-tip. This will keep the incision clean and make sure you have the best possible healing experience.
• Apply topical ointment to your incision, and make sure that you keep the incision covered with it for as long as you can.
• Apply an ice pack to the site if recommended. Some patients also find frozen peas highly effective.
• When you go to bed at night, make sure that your head is at a higher level than your heart.
• Slight bleeding around the incision site is normal for the first few days, so it is important to keep up your appearance and practice good hygiene by keeping it cleaned and covered.
Cancerous tissue growth can be extensive. Losing facial tissue to cancer can be frightening, especially when it affects the lips, nose, or the area around the eyes. A restoration procedure is absolutely vital for the health of the patient.
What Can You Expect?
Planning a microsurgical reconstruction requires a detailed evaluation of your body and the right expectations. You may have to undergo a few cosmetic alterations, but a skilled surgeon will make sure that the borrowed tissue will come from areas that experience very little functional loss for your maximum gain.
Contact Our Office
Contact us to learn more about your reconstructive surgery options following a Mohs surgery for skin cancer. Dr. Richard A. Bartlett, a board-certified plastic surgeon, is one of Boston’s most trusted doctors. Using his in-depth medical knowledge and skillful artistry, he will help you get the reconstructive services you desire.
