While skin cancer can be found almost anywhere on the body, the nose is one of the most common areas. Mohs surgery can be performed to remove the cancerous growth; however, depending on the size of the cancer and the margin required, there can be visible evidence of the treatment. Nasal reconstruction is performed to improve the appearance and protect your nose after Mohs surgery.
Mohs surgery is performed to remove skin cancer growths while preserving as much healthy tissue as possible. Mohs surgery ensures that all cancerous tissue is safely removed before nasal reconstruction repairs the aesthetic appearance of the nose.
While this technique can spare more tissue than other skin cancer treatments, it may still result in noticeable tissue loss. Nasal reconstruction uses different forms of skin closures or grafts to repair the loss that was required to treat your skin cancer.
When many skin cancers are removed, patients are left with a large open wound that has to be closed for protection. Nasal reconstruction not only improves the cosmetic appearance of the nose but protects the area from external factors.
Your reconstructive options depend on the amount of tissue being removed from the nose. These options will be discussed further during the consultation with Dr. Hung.
Direct linear closure is a reconstructive technique used after Mohs surgery that brings the two edges of the wound together to create one linear line. This option is typically performed when there is a large wound on the nose.
The local flap technique covers the open wound on the nose with the nearby skin. Often, the surrounding skin can be stretched to cover the injury.
Skin grafting is performed when a large piece of tissue has been removed from the nose, and the local flap technique is not sufficient to cover the wound. Your surgeon will harvest tissue from another part of the body to transfer to the nose.
Much like the full-thickness skin graft, the distant flap, such as the paramedian forehead flap, covers the wound with transferred donor tissue. The paramedian forehead flap uses a small portion of tissue from the middle of the forehead.
Your recovery period after nasal reconstruction depends on the size of the wound. You will develop some swelling and bruising that can last for a few days to a few weeks. Most often, a full recovery can take between four and six weeks.
Mohs surgery removes cancerous tissue. Therefore, you will experience scarring. The size of the scar depends on how much tissue was removed and what reconstruction technique was used.
The cost of this procedure may range depending on the size of the reconstructed area. Because this nasal reconstruction follows treatment for skin cancer, insurance might be accepted. This and all other cost factors will be discussed during your consultation.
After the surgery, you will most likely develop some discomfort. Over-the-counter medications, such as TYLENOL®, can be taken to ease the pain. Ice packs can help reduce the swelling.
While a skin cancer diagnosis is frightening, you can feel comforted with the knowledge that Mohs surgery will remove the cancer while causing the least amount of damage to your surrounding tissues.
During your consultation with Dr. Hung, he will examine your skin cancer to determine if you are an appropriate candidate for Mohs surgery and which type of nasal reconstruction would be best for you.
Dr. Hung will numb the treatment area. He will then use a scalpel to gently remove the cancerous lesion, layer by layer. This removal will continue until all cancerous growth (and a margin) is removed. Depending on the size and placement of the cancer, the wound will be treated and closed.
While rare, complications can occur with the anesthesia. Additional side effects include bleeding, tenderness, and pain.
Before undergoing surgery, you will need to meet with your surgeon to discuss your medical history. You will be asked to stop drinking and smoking before treatment to prevent any complications.