Skin cancer is an unfortunate, albeit fairly common, problem that can affect any part of the body. It is of particular concern when it affects the face and nearby structures due to the possible impact to an individual’s facial appearance and function. Common techniques for surgical removal of skin cancers that are often employed on other parts of the body (such as wide local excision, which can result in oversized defects) are often not ideal for surgical removal of skin cancers of the face. Mohs micrographic surgery, performed by a fellowship-trained dermatologist, is a highly specialized technique that results in a highest cure rates with the smallest possible defects.
Large and/or recurrent skin cancers of the face and head present multiple challenges for patients and surgeons. First, removing the cancer with the best chance of permanent cure requires full surgical margin clearance and coordination of additional care (e.g., radiation therapy) as needed. Additionally, large skin and soft tissue defects created by removal of the tumor require complex and often multi-stage reconstruction to achieve an acceptable appearance.
It is well established that dermatologic surgeons using Mohs margin techniques provide the best chance for control of skin cancers. This method allows for confident reading of 100% of the tissue edges surrounding the tumor to ensure full removal of cancerous cells. However, at most hospitals, coordination of this technical tissue read with large cancer removal and reconstruction under anesthesia is not logistically possible. As a result, many larger cancers receive less reliable oncologic management.
At Cleveland Clinic, we have an established, coordinated approach which combines the expertise of dermatologic and cancer surgeons with reconstructive surgeons. This allows for the best tumor removal and simultaneous facial reconstruction under one anesthesia.
In addition, we have experts in secondary reconstruction and scar revision. Our goal in all instances is to make reconstructions unnoticeable and restore normal appearance and function for our patients.
Conditions and Treatments
Advanced and/or recurrent skin cancers
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Cleveland Clinic Center for Facial Reconstruction and Facial Nerve Disorders offers consultations at Cleveland Clinic's main campus.
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