Skin Cancer Gallery

A woman in her mid 70’s with a large defect of the nose after Moh’s excision of a basal cell carcinoma. She has had previous basal cell carcinoma of her nose with flap repair. Her case is complicated by being on anticoagulation for atrial fibrillation. A skin graft does not give a good match on the lower nose, and because of her anticoagulation a 3 stage forehead flap would have been more of a challenge for her. Although the defect is large, she had just enough skin to perform a Rieger flap, sometimes called a “bishop’s mitre” flap because it looks like a bishop’s hat. This flap is based on the nasalis muscle and is slid down the nose to repair the defect. It does elevate the nasal tip and can sometimes work well in the older patient whose nose has drooped with age. She does have some asymmetry of the nostrils, but is able to pass the “little girl” test and not look deformed. She is shown one year after her surgery.

A man in his early 60’s with a large defect of his left temple and cheek following Moh’s excision of a recurrent basal cell carcinoma. He is shown after Mohs and just before repair, and again, 4 ½ months after and extended Mustarde cervical facial flap. The skin of the cheek and neck is widely elevated in this procedure and transferred into the defect. This gives a much better color and texture match than a skin graft. We can expect the scar to continue to fade further over the next 18 months.

A man with a large defect of his nose after Moh’s excision of a BCCA is shown 6 months after a Reiger flap repair. The skin of the nose is a better match for the nasal tip skin than would be a skin graft.

A woman in her early 70’s with a squamous cell carcinoma of her lower lip. The lower lip is a common site for skin cancer from sun exposure. She is shown immediately after Moh’s excision of her skin cancer. The remaining portion of the lip has “actinic chelitis” which is just the medical term for sun damage that has not yet progressed to skin cancer. The key word is “yet”. In a case such as this one, it is often best to excise the remaining sun damaged portion of the lower lip “vermillion” ( the red part of the lip) and then advance the lip mucosa from inside the lip( that has not been exposed to the sun) forward. This is sometimes called a “lip shave” procedure. This is what we decided to do here. She is shown 4 months after surgery, and has a normal appearance of the lip, even from a very close inspection.

A man in his late 70’s who had a complicated defect of his left oral commissure ( the left corner of his mouth) after Moh’s excision of a Squamous cell Carcinoma. He is shown 2 years after reconstruction using the method Zisser described in 1995.