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”.
A woman in her early 80’s with a basal cell carcinoma of her left ala. The ala can be a challenging area to reconstruct and typically requires several stages. She had a first stage with a nasolabial pedicle flap and ear cartilage graft. She returned to have this divided 4 weeks later. A second stage to better refine the flap contour was performed 9 months later. She is shown before, just after Moh’s excision and again, 5 months after her final procedure.
A woman in her mid 70’s s/p moh’s excision of a squamous cell carcinoma (SCCA) of the lower lip. The lower lip is prone to more sun exposure and when a patient develops a scca in this area they typically have “actinic cheilitis” which is sun damage of the rest of the pink portion (vermillion) of the lower lip that is prone to develop more skin cancers. It is usually a good idea to remove the entire remaining sun damaged vermillion and advance the lip forward- called a “lip shave” or “vermillionectomy”. That was done here and her lip is shown 11 months after surgery-the scar Is nearly imperceptible even with a close up view and the lip has normal function and motion, but the vermillion that has been brought forward from inside the lip has not had chronic sun exposure and is not therefore prone to develop another scca.
A 90 yo woman with a large defect of her upper lip after Moh’s excision of a squamous cell carcinoma. She is shown just after Mohs surgery and again, 6 weeks after repair with a paranasal advancement flap.
A 5 month follow up on a challenging case with a large defect of the nose after Mohs surgery for a Basal Cell Carcinoma that had been present for more than a year. He did not wish to have a 2 or 3 stage forehead flap and so we started with a large skin/fat composite graft from his cheek with the idea that if we did not like the result he could always return for the more complex procedure. He is shown just after Mohs surgery and again, 5 months after the skin/fat composite graft. The result is acceptable and should continue to fade a little with time.
A 72 yo woman with a lentigo maligna melanoma/ melanoma in situ of her left temple and forehead with a large defect after modified Mohs excision by the dermatologist. I reconstructed her with a full thickness skin graft from the left neck. She is shown just after modified Mohs and again, 18 months after surgery. The color match of the neck skin is good on the forehead and the scar just above her collarbone on the left is difficult to see.