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About the procedure Repair following Mohs Micrographic Surgery

Our Philosophy on Post-Mohs Surgical Repair

At AR Plastic Surgery, we provide reconstructive surgery following Mohs micrographic surgery in collaboration with dermatologists and Mohs surgeons. Mohs surgery is a specialised procedure used to remove certain types of skin cancer, often on the face or other sensitive areas. Once the skin cancer is fully removed, some wounds may require surgical repair to help protect the area and support healing.

The surgeons who operate at AR Plastic Surgery assess each wound individually to determine the most suitable repair method. This decision is based on the location, size, and depth of the wound, along with the condition of the surrounding skin. We work closely with the referring doctor to plan and carry out reconstruction at the appropriate time.

Our approach focuses on preserving function and providing stable wound closure. In areas such as the nose, lips, eyelids, or ears, extra care is taken to protect important structures while closing the wound. Patients are provided with clear explanations about the planned repair, including what to expect during recovery and follow-up.

Understanding Repair After Mohs Surgery

Mohs micrographic surgery removes skin cancer layer by layer, with each layer examined under a microscope until the cancer is fully cleared. It is commonly used for basal cell carcinoma and squamous cell carcinoma, especially when located on the face or other high-risk areas. The goal of Mohs surgery is to remove as little healthy tissue as possible while ensuring all cancer is removed.

The size and shape of the wound left after surgery can vary. Some wounds are small and can be closed with stitches or allowed to heal on their own. Others are larger or located in areas where healing without reconstruction could affect nearby structures or movement.

At AR Plastic Surgery, the repair process is tailored to each patient’s needs. A full assessment is carried out before deciding on the appropriate technique. Patients are encouraged to ask questions, and every step of the process is explained before surgery is scheduled.

Types of Surgical Repair

Several techniques may be used to repair a wound after Mohs surgery. The method chosen depends on the wound’s location, size, depth, and how much healthy skin is available nearby. The following are the most common types of surgical repair:

  • Direct Closure: This involves closing the wound with stitches by bringing the skin edges together. It is used when the wound is small, and there is enough flexible skin in the area. This technique may be used on various parts of the body, depending on tissue availability.
  • Local Flap: A local flap uses nearby skin and tissue that remain connected to their blood supply. This flap is moved or rotated into place to cover the wound. It is commonly used in areas like the face, where matching skin texture and preserving function are important.
  • Skin Graft: A skin graft involves taking a thin layer of skin from another part of the body and placing it over the wound. The grafted skin is secured in place and gradually forms a new surface over the wound. This technique is used when there is not enough surrounding skin to close the area directly.

 
All repair options are discussed during the consultation. Patients are given time to consider the recommended method and ask questions before surgery.

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What to Expect on the Day of the Procedure

Patients are welcomed to the surgical facility and supported by the clinical team throughout the process. The area is marked, the surgical plan is reviewed, and patients are encouraged to ask any remaining questions. The type of anaesthesia used—local or general—depends on the location and extent of the wound and is discussed ahead of time.

In the operating room, the planned repair method is carried out—whether that is direct closure, a local flap, or a skin graft. Care is taken to protect nearby structures, such as the eyes, lips, or nostrils, when working in sensitive areas. Once the repair is complete, dressings are applied and post-operative care is explained.

Some repairs may take longer, depending on the size of the wound and the technique used. Patients must have someone accompany them home, especially if general anaesthesia is used. Before leaving, they are given clear instructions for home care and a phone number to call if they have concerns once they are home.

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Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors, including the individual’s genetics, diet and exercise. Some images may have the patient’s tattoos, jewellery or other identifiable items blurred to protect patient identities.

Aftercare and Recovery

Recovery depends on the type of repair and the area of the body treated. Some patients may experience swelling, bruising, or tightness around the surgical site. These symptoms usually settle with rest and proper care during the first days after surgery.

Patients are provided with instructions on how to look after the wound, including how to keep the area clean and when to change dressings. They are advised to avoid activities that place tension on the wound or increase swelling. Sun protection is also recommended, as new scars are sensitive to sunlight.

Follow-up visits are arranged to check how the wound is healing and to remove any sutures if needed. Sutures are usually removed within 5 to 10 days, depending on the location and type of closure used. Some patients may benefit from additional scar care, such as silicone dressings or massage, once the wound has healed.

Potential Risks

As with any surgical procedure, there are risks involved in repair after Mohs micrographic surgery. These risks are discussed in detail during the consultation to ensure patients are informed. Potential risks include:

  • Infection
  • Bleeding or haematoma (blood collection under the skin)
  • Wound breakdown or delayed healing
  • Scarring
  • Changes in skin sensation
  • Poor graft or flap healing
  • Reaction to anaesthesia

Patients are given information about how to recognise early signs of complications. This may include increased pain, redness, swelling, or fluid coming from the wound. A clear plan is provided for follow-up, and patients are advised to contact the clinic promptly if they have any concerns.

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