Mohs surgery is the gold standard for removing certain skin cancers, especially on the face. While the technique preserves as much healthy tissue as possible, patients are often left with a wound that requires reconstruction. The type of reconstruction depends on the size, location, and depth of the defect. Options include natural healing, skin grafts, and flaps. Texas Surgical Dermatology, led by Dr. Tri H. Nguyen who is a Mohs fellowship-trained specialist, provides Mohs surgery to patients in Houston, Katy, Spring, The Woodlands, Texas, and surrounding locations.
Healing by Secondary Intention
For smaller, superficial wounds, the skin can heal naturally over time without surgical closure. Known as secondary intention healing, this approach relies on the body’s natural regenerative ability. While healing takes longer, scars can sometimes be less noticeable, especially in concave areas like the inner corner of the eye.
Skin Grafts
In cases where more coverage is needed, surgeons may use a skin graft, transferring skin from another part of the body (the donor site) to cover the wound. Full-thickness grafts provide a more natural match in visible areas like the face, while split-thickness grafts may be used for larger surface areas.
Pros of grafts:
- Useful for larger wounds
- Can restore coverage quickly
- Often effective in flat areas
Cons of grafts:
- May not match skin tone perfectly
- Risk of graft failure if blood supply doesn’t develop
Flaps
Local flaps are often preferred for facial reconstruction after Mohs. A flap uses nearby skin and tissue, rotated or advanced into the wound while maintaining its own blood supply. This provides better color and texture match than grafts. Types include advancement flaps, rotation flaps, and transposition flaps.
Pros of flaps:
- Superior cosmetic outcomes, especially on the face
- Better long-term integration with surrounding tissue
- Lower risk of rejection compared to grafts
Cons of flaps:
- Technically more complex
- May require longer healing and follow-up care
Factors That Influence Reconstruction Choice
- Size and depth of the defect
- Location (nose, cheek, eyelid, lip, ear, etc.)
- Patient’s health and healing capacity
- Cosmetic considerations and personal preference
Mohs surgery is highly effective for cancer removal, but reconstruction is equally important for both function and appearance. From natural healing to skin grafts and flaps, the right choice depends on the specific case and the surgeon’s expertise.
FOR MORE INFORMATION CONTACT OUR BOARD CERTIFIED IN DERMATOLOGISTS AT TEXAS SURGICAL DERMATOLOGY IN SPRING, TX
For more information on procedures and treatments offered at Texas Surgical Dermatology PA please call 832.663.6566 or click here to contact our dermatologists. Helping patients in Houston, The Woodlands, Spring, Katy and other surrounding areas of Texas.
