Believe it or not, 40-50 percent of Americans develop skin cancer during their lifetime.
Fortunately, many common types of skin cancers can be treated by dermatologists and facial plastic surgeons using Mohs micrographic surgery, an advanced surgical procedure used to remove skin cancer. According to the Skin Cancer Foundation, Mohs surgery is considered the most effective technique for treating many basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs), the two most common types of skin cancer.
During Mohs surgery, a doctor (often a dermatologist) progressively removes thin layers of cancer-containing skin until only cancer free tissue remains. The goal is to remove as much skin cancer as possible while preserving the surrounding healthy tissue. Mohs surgery allows doctors to verify that all cancer cells have been removed and reduces the need for additional treatments or surgeries.
If the surgical area is extensive or complex, after Mohs excision is complete, a dermatologist will refer the patient to a specialized facial plastic surgeon, like Dr. Jean-Paul Azzi, to perform Mohs reconstruction.
“Dermatologists frequently ask me to repair any cosmetically sensitive area or any area they aren’t comfortable repairing," said Dr. Azzi. “Most commonly, this is on the face and includes but isn't limited to - cheeks, nose, ears, eyelids, neck, lips and scalp.”
Dr. Azzi prefers to repair defects the same day as they are made by the dermatologist. “This is mostly for patient comfort," he says. “But defects can be repaired days or weeks after the ‘hole’ is made. I have had people come in over a month after the defect was made. These patients typically were told by their dermatologist that the defect cannot be repaired and will heal on its own. This can be an issue with patients as healing can take months to occur. In these circumstances, I freshen the edges of the defect and perform the repair."
Fortunately, most dermatologists are conscientious enough to actually arrange for reconstruction with a facial plastic surgeon before the MOHs procedure is even performed. “In my practice, we routinely coordinate with dermatologists - sometimes from several hours away,” says Dr. Azzi. “This allows patients to come in for a consultation with me to evaluate the skin cancer before excision and allow the patient to come for reconstruction immediately after the MOHs excision is complete.”
Just like the Mohs excision, the reconstruction is performed right in Dr. Azzi’s office under local anesthesia.”
“Every defect or ‘hole’ is different,” says Dr. Azzi. Before reconstruction, Dr. Azzi carefully evaluates the size, location, skin laxity and orientation of every defect before he chooses a reconstructive option. “I use countless types of flaps and grafts to repair defects all over the face and neck,” he adds.
“Flaps are the most common reconstructive method I use. Another term for them is ‘adjacent tissue transfer.’ These involve designing a reconstruction where tissue next to the flap is moved into the defect so it is repaired. Grafts involve borrowing skin from another part of the face or body and transferring it to the defect site,” says Dr. Azzi.
As you can see in the before and after images below, Dr. Azzi’s specialized surgical skill produces results that are nearly imperceptible.
If you are one of the many Americans diagnosed with skin cancer, you can feel confident knowing that Mohs surgery has a 99 percent rate of successful cancer removal, and if you choose a specialized surgeon like Dr. Azzi, the results of your Mohs reconstruction will be almost invisible.
For consultations, please call (561) 429-5403 or click here. The Palm Beach Center for Facial Plastic & Laser Surgery is conveniently located in Jupiter and Palm City, Florida. We serve patients in the following South Florida areas and beyond: Jupiter, Palm Beach Gardens, Palm Beach, West Palm Beach, Tequesta, Hobe Sound, Stuart, Palm City, Vero Beach and Jensen Beach. Live somewhere else? No problem, click here.