A man in his early 60’s who had a basal cell carcinoma of the nose. The defect after mohs surgery was 1.7 cm and on the large side to perform a local flap. Typically looks like a big scab at 2 weeks. By 6 weeks the scab comes off and the deep layers are healed. He is shown before and again, 11 months after a skin-fat composite graft.
A woman in her 70’s who is 6 months after composite skin-fat graft reconstruction of a post-Mohs defect of her lower nose
Discussion. A full thickness skin graft can work well on the upper nose but does not typically match the texture and color of the kin on the lower nose. A composite skin-fat graft which includes the fat, typically gives a much better match in the lower nose, as is seen here.
A man in his early 80’s with a large defect of his left ear following Moh’s excision of a squamous cell carcinoma. The ear was reduced and reshaped (“reduction otoplasty”) to give the ear a smaller but still normal appearance. Although the ear is smaller, we do not typically view both ears at the same time and it does not appear deformed. He passes the “little girl” test. The little boys and girls don’t ask their mother “what happened to that man?”
He is shone after his moh’s surgery and immediately after reconstruction.
A man in his early 70’s after mohs surgery to remove a basal cell carcinoma of his ear leaving him with a defect of the conchal bowl and ear canal. He is shown just after mohs surgery and again, 6 weeks after a revolving door flap. This takes a flap based on the blood supply behind the ear and rotates it like a revolving door to repair the defect. The Donor site is usually able to be closed behind the ear. This is an elegant solution for a defect in this part of the ear.
A woman in her mid 60’s show is seen immediately after Mohs excision of a basal cell carcinoma of the left inferior eyelid. She is shown before and again, 2 months after eyelid reconstruction with a Tenzel Semicircular flap and lateral canthus reconstruction with a periosteal flap under local with IV sedation.
Scars will typically fade and improve over the next year or longer.
A woman in her later 70’s with a large defect of her ear after Mohs excision of a Basal Cell Carcinoma. Her earlobes have drooped with age. She is shown before surgery, just after Mohs excision and again, 4 ½ months after a reduction otoplasty/earlobe lift procedure that pulled the excess tissues up from the lower ear to repair the defect. A modified Antia-Buch type procedure. The right ear is now more youthful in appearance without as much drooping of the earlobe and although the right ear is smaller than the left ear from a front view, no one notices because the ear has a normal shape. Scars are at their reddest and thickest at 6 weeks and typically fade and improve over the next 2 years.
A health care professional in her early 60’s with a large basal cell carcinoma of her right upper lip. She is shown just after Moh’s excision and then again, 5 months after a paranasal advancement flap. Scars will typically continue to fade and improve over the first two years.
A retired nurse in her late 70’s with a spindle cell pleomorphic cancer of her right forehead. She is shown just after modified Mohs excision by the Mohs surgeon and again, 7 ½ months after an inverted T-plasty repair of the forehead followed by postoperative radiation. With an inverted T pasty, the defect is converted to an upside down “V” and the sides are advanced and repaired to give the appearance of an upside down “T”.