Philipp Franck M.D.

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Eyelid reconstruction after Mohs surgery

Mohs surgery is a type of skin cancer treatment that removes the cancerous tissue layer by layer. The surgery is usually performed on the face, including eyelids. Eyelid reconstruction after Mohs surgery can be a challenging and delicate process. There are several methods that can be used to reconstruct the eyelid, and the best method depends on the individual patient's needs. In this blog post, we will discuss some of the options for eyelid reconstruction after Mohs surgery.


What is Mohs surgery and why is it done?

Mohs surgery is a precise form of skin cancer treatment that involves removing the facial skin cancer layer by layer until only healthy tissue remains. Skin cancer lesions can appear on the upper and lower eyelids. Upper eyelid and lower eyelid reconstruction after Mohs surgery is a standard procedure for patients who have had Mohs eyelid surgery to remove basal cell carcinoma on their lower lids. This type of reconstructive surgery rebuilds parts of the eyelid, including restoring sensation, movement, shape, and size while ensuring the strength of the lid is conserved. Lower eyelid reconstruction with Mohs surgery often results in natural appearance and anatomical outcomes, as it minimizes any visible scarring after healing. Additionally, tissue repair during an eyelid reconstruction can help preserve or restore vision patterns and visual acuity when treating eyelids that are near critical eye structures. Ultimately, Mohs surgery and its associated reconstructive procedures offer an excellent opportunity to remove skin cancers from delicate areas like around the eyes with minimal risk to tissue function and maximum potential for cosmetic results.


How is eyelid reconstruction performed after Mohs surgery?

Eyelid reconstruction is a common plastic surgery that can follow after Mohs surgery. Mohs surgery is a method of removing skin cancer, usually by surgically cutting it from around the affected area and then treating it with other methods such as cryosurgery or electrodesiccation. Depending on the depth of the resulting defect after skin cancer removal, a qualified plastic surgeon has numerous options for reconstruction. Superficial lesions can sometimes heal on their own or be covered with a small skin graft. Typically, this involves using a flap technique or relying on adjacent tissue to cover up any adverse effects and create normal-looking eyelids. Sometimes additional procedures are necessary, such as minor lid tightening or tightening surrounding facial muscles to regain symmetry within the face. It requires a thorough understanding of the eyelid anatomy to offer the best possible solution. In cases of large defects requiring advanced reconstructive techniques, your treatment team might involve multiple doctors including a Dermatologist, Plastic Surgeon, and Oculoplastic surgeon. With proper care and attention, patients can get back the comfort they felt before their diagnosis with promising results.


What is a skin graft?

A skin graft is a medical procedure where healthy skin tissue is taken from one area and transplanted to another. Skin grafts can be partial thickness or full-thickness. For facial reconstruction, a full-thickness skin graft is typically preferred due to its superior aesthetics. An excellent option for eyelid reconstruction is the use of excess upper eyelid skin from the other side.


What are the benefits of eyelid reconstruction after Mohs surgery?

Eyelid reconstruction after Mohs surgery is a reconstructive procedure that can improve functioning, restore normal appearance, and provide long-term cosmetic benefits. One of the most critical aspects of eyelid reconstruction surgery is its ability to restore the normal anatomy and symmetry of the eye. The upper eyelid covers the majority of the globe and is essential for protection and lubrication. An upper eyelid defect should be reconstructed using eyelid tissue or tissue of similar texture for optimal results. The lower eyelid provides support and suspension. During reconstruction, it can also be tightened if necessary. For patients who have experienced disfigurement from Mohs surgery, this procedure can help them find the confidence to overcome their physical changes and regain their ordinary activities. Additionally, improvement of vision, as well as decreased dry eyes and lagophthalmos can result from a successful eyelid reconstruction after Mohs surgery. It is crucial for patients to understand the potential risks associated with the procedure in order to make an informed decision about whether or not it is right for them.


Are there any risks associated with eyelid reconstruction after Mohs surgery?

Eyelid reconstruction after eyelid skin cancer excision can be an effective way to restore shape and function, however it is important to be aware of the risks associated with this procedure. Common side effects of eyelid reconstructive surgery include bruising, tenderness, swelling, and temporary blurred vision. In some cases, there is a risk of infection or skin tissue necrosis, which may require additional treatment. Additionally, the reconstructed eyelid may differ aesthetically from the original eyelid and in some cases may need further correcting procedures. Generally, these risks can be managed through pre-operative evaluation and appropriate post-operative care. Before deciding whether or not to proceed with eyelid reconstruction surgery due to skin cancer, it is important for patients to discuss their options carefully with a board-certified surgeon so they can make an informed decision about their health and safety.


How can I prepare for my eyelid reconstruction surgery?

First and foremost, it is important to discuss the findings and pathology with your dermatologist or surgeon. Prior to reconstruction, the eyelid margins have to be free of any skin cancer. Preparing for eyelid reconstruction surgery can be a challenging and complicated process. Before your surgery, research facts about the procedure so you know what to expect. Talk to your doctor to have your questions answered and ensure you have a thorough understanding of the risks associated with such a procedure. Additionally, it is essential to stick to any instructions given by your doctor before your operation. Lastly, mentally prepare yourself by staying positive throughout the preparation and recovery stages of this surgical experience.


What can I expect after my eyelid reconstruction surgery is complete?

After a successful eyelid reconstruction surgery, it is important that you take the proper steps to ensure a full recovery. You should be prepared to rest for an extended period of time, depending on the type of surgery performed. Swelling and bruising can be expected in the area around your eyes, and they should gradually decrease over time. In some cases, you may have limitations with certain activities or exercises. Sometimes the eyelid margin is temporarily suspended to support the healing process. You may also need to attend regular follow-up appointments with your doctor to monitor your progress and healing. It is important to follow all instructions given by your doctor after surgery so that you can recover as quickly as possible while reducing any risks associated with postoperative care.


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