Mohs Reconstructive Surgery

Reconstructive surgery after Mohs refers to a range of procedures used to close or repair the area where the skin cancer was removed. While some small wounds can heal on their own or be closed with simple stitches, others require more advanced techniques to minimize scarring and preserve the skin’s natural appearance and movement.

The face is the most common area treated with Mohs surgery, and it is also where reconstructive surgery is most often performed. Areas such as the nose, eyelids, lips, and ears pose special challenges because they are highly visible and play an important role in facial expression and function. Reconstructive techniques are carefully chosen to balance cosmetic appearance with functional restoration.

Reconstruction after Mohs surgery is not one-size-fits-all. It is in every sense of the word – an art. The right approach depends not just on the size of the surgical site, the depth of the wound, and its location, but also on properly assessing the patient, their skin properties, movements, and objectives. Board-certified dermatologist and Mohs surgeon Dr. Joshua Freedman specializes in tailoring each procedure to the individual patient’s needs, ensuring the best possible outcome. Common options include:

• Primary closure: For smaller wounds, the simplest and most common option is to bring the wound edges together with stitches. This is called primary closure. It provides a straightforward solution with excellent results, especially when the wound is in a flexible area of the skin.
• Skin grafts: When the wound is too large to close directly, a skin graft may be used. This involves taking healthy skin from another part of the body, often from behind the ear or the upper thigh, and carefully placing it over the wound. Skin grafts can restore coverage and function, though the texture and color may differ slightly from the surrounding skin.
• Local flaps: In some cases, tissue from the surrounding area is rotated or repositioned to cover the defect. This technique, known as a local flap, is often used on the nose, cheeks, or forehead. Because the tissue comes from a nearby area, it usually matches well in terms of color and texture, creating a more natural appearance.
• Regional or advanced flaps: For larger or more complex wounds, tissue from a neighboring region of the face or body may be used. This allows for more precise reconstruction and can preserve the natural contour of the face. These procedures require a high level of expertise to achieve optimal functional and cosmetic results.
• Secondary intention healing: Sometimes, the best approach is to let the wound heal naturally without surgical closure. This method, called secondary intention healing, is used for wounds in areas where natural healing produces good cosmetic results, such as the cheeks or forehead. Regular monitoring ensures the wound heals properly over several weeks.

Reconstructive surgery after Mohs is not only about closing a wound. It provides several important benefits:

• Restoring appearance – Skin cancer often affects visible areas of the face. Reconstructive surgery helps reduce scarring and restore natural facial contours, allowing patients to feel confident in their appearance after treatment.
• Preserving function – Areas like the eyelids, nose, and lips are critical for vision, breathing, and speaking. Reconstruction ensures that these vital functions are not compromised after surgery.
• Improved healing – Closing the wound with reconstructive techniques often allows for faster healing compared to letting the wound heal on its own. It also reduces the risk of infection and other complications.
• Emotional well-being – Completing cancer treatment is already a major milestone, and restoring appearance helps patients move forward with greater peace of mind. Many patients find that reconstruction is the step that helps them feel whole again after cancer treatment.
• Long-lasting results – Because reconstructive surgery focuses on both function and aesthetics, patients benefit from durable, natural-looking outcomes that stand the test of time.

Recovery depends on the type of reconstruction performed. Some patients may have only a few stitches removed within a week, while others may require more detailed follow-up care. Swelling, bruising, and mild discomfort are common in the first days after surgery, but these typically improve quickly. Mohs surgeon Dr. Freedman provides detailed aftercare instructions and monitors healing closely to ensure the best possible outcome.

In most cases, patients can resume normal activities within a short time. Over the following weeks, the skin continues to heal, and scars gradually fade. In the long term, results are often so natural that it becomes difficult to tell where surgery was performed.

As a medical and surgical dermatologist in Swedesboro, New Jersey, Dr. Joshua Freedman brings both artistry and medical expertise to reconstructive surgery after Mohs. His advanced training allows him to achieve results that prioritize not only curing cancer but also helping patients look and feel like themselves again. Dr. Freedman understands that every patient has unique concerns, and he works closely with each individual to create a personalized plan for reconstruction and recovery.