Not every patient who undergoes Mohs surgery may require facial reconstruction. However, there are times when the surgeon will recommend undergoing reconstructive surgery to prevent scar contracture. In cases where surgery is not required, this may be done based on the patient’s preference. Most dermatologists have observed that facial reconstruction helps to accelerate the healing of the wound as well as improve its appearance. Therefore, if you or anyone you know plans on undergoing Mohs surgery, you should book an appointment with Dr. Skaggs of the Kentucky Skin Cancer Center, an expert in facial reconstruction in Bowling Green.
Facial reconstruction is typically performed the same day as the Mohs surgery. There are various techniques used by surgeons to perform facial reconstruction. One of the most preferred techniques is the flap technique, which involves setting a piece of skin tissue in an injured area.
Benefits Of The Flap Technique In Facial Reconstruction
The benefit of using the flap technique is that the skin used better matches the skin tone compared to skin used from grafts. This is because flaps do have a blood supply since they are attached to the body.
The use of flaps helps to prevent shrinkage in areas such as the nose, which could lead to distortion. Also, the flap technique is better compared to tissue expansion because the latter requires regular visits to the doctor and often creates a repulsive bulge during the process.
Types Of Flap Techniques
There are two categories of flap surgery, namely the local (pedicled) flap, and the free flap. The local flap involves moving, freeing, or rotating tissue from an adjacent body part. This is done in a specific manner to cover the injured area while ensuring that it stays attached to the body.
The free flap technique entails transplanting tissue from another body area, which is then surgically rejoined to blood vessels close to the injured area.
There are four main ways of executing the local (pedicled) flap technique, namely:
· Advancement Flap
Advancement flaps are those that slide when closing a defect. This technique is best preferred for parts that have excellent elasticity. Advancement flaps may include unipedicle, V-Y flaps, and bipedicle.
A unipedicle advancement flap is one where the flap and the injured area share a border that determines the body part that will be used to carry out the advancement flap. A bipedicle advancement flap is a tissue that is designed to be longer than the injured area. This technique is often used in patients who have extensive scalp and tiny nasal defects.
The V-Y advancement flap is designed to be of the same size as the area being reconstructed. This technique is executed when repairing the forehead, lip, nose, and cheek defects.
· Rotation Flap
Rotation flaps use tissue from the adjacent area of the injured part to cover the defect. This technique is used for the cheek and scalp as well as nose defects.
· Transposition Flap
Transposition flaps are flaps that may be designed remotely from the injured area. This technique is useful in repairing tiny and medium-size deformities of the nose and cheek area.
· Interpolation Flap
An interpolated flap procedure is a two-step process that requires dividing the pedicle before setting the flap. This technique is used when reconstructing nasal deformities.
Possible Complications During Facial Reconstructive Surgeries
This procedure is not free of risks. Some of the complications include infections, excessive bleeding, tissue death, and overall bad results that may require revision surgery.
Finally, facial reconstruction should only be done by board-certified surgeons with extensive experience. Dr. Skaggs from the Kentucky Skin Cancer Center is an expert in both cancer surgery and facial reconstruction procedures.
