mohs-surgery-and-skin-cancerSkin cancer is the most common cancer in the United States, exceeding the rates of breast, prostate, lung and colon cancers combined.  One in five Americans will develop skin cancer, and more than half of those will go on to develop an additional skin cancer. 

Removing these cancerous tumors presents certain challenges. It’s difficult to eliminate all cancerous cells and save as much healthy tissue as possible. After the cancer is removed, patients are often left with large “holes” or facial defects as a result. Removing even just a few millimeters of skin has a dramatic, and often devastating, effect on facial appearance. 

Now, a revolutionary new treatment called Mohs has refined how physicians treat skin cancer.

What is Mohs surgery?

Mohs is a surgical technique that enables the dermatologist to remove all cancerous tissue without damaging healthy areas. During surgery, the doctor takes a thin slice of skin from the affected area. It’s then examined under a microscope to see if it contains cancer cells. This process is repeated until the doctor discovers tissue that is cancer free. 

Mohs is the perfect technique for treating skin cancers in facial areas where it’s important to keep as much healthy tissue as possible. It’s also a good option for aggressive skin cancers or cancers with irregular or hard-to-define borders.

Other advantages of Mohs include: 

  • It reduces the need for additional surgery.
  • You immediately know the results before you leave your appointment.
  • It increases the chances of a cure.
  •  It can be done on an outpatient basis.
  • The procedure typically only uses a local anesthetic.

However, after Mohs surgery has been completed, the process is not over. 

Depending upon where the cancer was located, there may be extensive defects or missing skin around the nose, eyelids or cheek. This is where our world-class physicians at Raleigh Capitol Ear, Nose and Throat can help.

What role do ENT doctors have in Mohs skin cancer treatment? 

After Mohs, patients frequently need extensive plastic surgery to repair facial defects caused after the skin cancers have been removed. ENT physicians have extensive knowledge of the intricate features of the nose and facial structures that make them a natural choice to for this delicate procedure.

At Raleigh Capitol Ear, Nose and Throat, we’re fortunate to have two of the best facial plastic surgeons in the country serving patients throughout the Triangle area. Their experience and wealth of knowledge enables us to provide the highest level of service.

Facial plastic surgery following Mohs

Sometimes, Mohs surgeons are able to close the wound with stitches or even allow it to heal on its own. This isn’t possible for extensive, deep cancers. In these cases, facial reconstruction after surgery can transform appearance and restore healthy tissue.

Dr. David Clark and Dr. Kevin Doyle are our plastic surgeons, both of whom are among the area’s most-respected physicians.  They have performed thousands of facial reconstructions involving skin grafts, bi-lobe flaps, and other procedures.

Through skin grafts, our surgeons use healthy pieces of skin from “donor” sites to repair damaged areas. The healthy skin is sewn in place to fill the space left after cancer removal. Eventually, blood vessels grow and circulation is restored to the area.

A flap procedure is similar, but the main difference is that fat and muscles are transplanted in addition to skin. This allows the area to have its own blood flow, so patients don’t have to wait for blood vessel growth in order for circulation to return. 

Other facial plastic surgeries may involve cartilage grafting, rearranging nasal skin and repairing nostril or nasal tip defects. 

The end result is that there is virtually no evidence that any surgery took place. You can see the amazing results in these pre- and post-operation photos.

Skin cancer risk factors

Of course, the best way to treat skin cancer is to prevent it from developing in the first place. Wearing sunscreen, seeking shade and having regular screenings can all help. Those who are fair-skinned or who have previously had a skin cancer are at higher risk. 

If you want to know more about skin cancer, you can take this educational quiz created by the American Cancer Society

Overcoming skin cancer is a victory worth celebrating. Once the cancer is removed, we realize that the journey is not yet over. After your dermatologist confirms all of the cancerous cells have been removed, we’ll be glad to speak with you about how the expertise of our facial plastic surgeons can restore your appearance and enhance your confidence.  


Raleigh Capitol Ear, Nose, and Throat is the area's premiere physician-owned ENT practice with six convenient locations throughout Wake County. Our board-certified physicians have extensive experience in treating both common and complex cases to help adults and children alike. We offer six local ENT offices throughout Raleigh, Cary, Garner and Wake Forest.  For more information or to schedule an appointment, contact us.

Sources:

Skin Cancer Foundation. “Skin Cancer Facts.” Online. 

The American Cancer Society. “Skin Cancer Quiz.” 

The Mayo Clinic. “Mohs Surgery Basics.” Online. 

The Raleigh Capitol Ear, Nose and Throat website.