MOHs Surgery Gallery
Basal Cell Carcinoma
The Basal Cell Carcinoma on a 75 year old male was treated with MOHs Micrographic Surgery. The resulting 1.3 x 1.5 cm defect was repaired by using the dorsal nasal flap. This flap is a local rotational flap that comprises the movement of the upper two thirds of the nose and forehead to repair defect of the tip less than 2 cm in diameter. The patient was extremely satisified with the results.
55 Year Old With a 5 Year History Of a Non-healing Lesion
This 55 year old patient presented with a 5 year history of a non-healing lesion on the left nasal alae. After tumor resection a 1.2 x 1.5 cm defect was repaired with a single rotation flap. A majority of the scar is creatively placed in the alar crease. The patient was very pleased at the outcome at 8 weeks post-op.
Infiltrating Basal Cell Carcinoma
This patient had an infiltrating Basal Cell Carcinoma that required 7 layers to clear with a sizable residual defect very close to her eye. The patient had significant laxity of the lateral cheek which was recruited to close the wound using a M plasty. Very minimal scarring is noted at 8 week follow-up.
Squamous Cell Carcinoma Of Frontal Scalp
This 70 year old male presented with a Squamous Cell Carcinoma of his frontal scalp. MOHs Micrographic Surgery was used for tumor clearance which resulted in a 3.5 x 3.5 cm defect. Significant undermining allowed for closure of this large defect by only a complex repair. The patient was relieved to avoid major reconstruction and still have great results.
Large Keratoacanthoma
This is a great example of a very large Keratoacanthoma (type of Squamous Cell Carcinoma) removed from a patient’s left antihelix. This was repaired using a full thickness skin graft from behind his left ear. An 8 week follow-up shows virtually no scar at the site.
Basal Cell Carcinoma Of the Left Chin
A 45 year old female presented with a Basal Cell Carcinoma of the left chin. Post operative defect size was 1.4 x 1.4 cm. A flap was initially designed as there was not much laxity of the skin but with significant undermining a complex closure was achieved. Again an 8 week follow-up showed no scarring.
Basal Cell Carcinoma
This 78 year old male was referred for a biopsy proven Basal Cell Carcinoma. Post-operative defect size was 2.0 x 1.8 cm, which was successfully closed with a complex linear closure without causing any asymmetry or lower lid pulling. A horizontal closure was not performed as lower lid pulling can occur which leads to future repairs.
Basal Cell Carcinoma
A 60 year old patient presented with a Basal Cell Carcinoma. After tumor clearance a post-operative defect of 1.5 x 1.4 cm is seen encroaching very close to the medial aspect of the eye. A M plasty flap was used to preserve healthy tissue and shorten the scare length. The patient was very pleased to have an excellent functional and cosmetic result.
Advancement Flap With Scar Line Placed In Natural Alar Crease
This is a 45 year old male with a 1.2 x 1.2 cm defect, post MOHs Surgery, on his left nose. The closure is an example of an advancement flap with the scar line placed in the natural alar crease. This approach allowed for a majority of the scar to be hidden in the normal skin fold leading to an excellent cosmetic result.
Squamous Cell Carcinoma in Right Nasal Alae
This 76 year old patient had a Squamous Cell Carcinoma in his right nasal alae. MOHs post-operative defect involved the majority of his nasal alae. A rotational flap was used to close this large defect. A rotational flap is curved or rotational and can be thought of as the closure of a triangular defect by rotating adjacent skin. An 8 week follow-up shows virtually no scarring.
Basal Cell Carcinoma Of Left Temple
This is a 78 year old male with a Basal Cell Carcinoma of his left temple. After tumor resection a 2.5 x 2.5 cm defect needed closure. In this case, part of the defect was closed by complex linear closure and the remaining by using the rotational flap. An 8 week follow-up shows no anatomical distortion and negligible scarring.
Basal Cell Carcinoma On Bridge Of Nose
This is a Basal Cell Carcinoma on the bridge of the nose of a 66 year old female. Although the defect involves a majority of her nasal bridge, there was enough laxity to close this as a complex linear closure. An 8 week follow-up shows an excellent cosmetic outcome.
Squamous Cell Carcinoma On Right Nose
A 55 year old male with a Squamous Cell Carcinoma on the right nose. The defect was not large at 1.2 x1.2 cm but involved botht the bridge and the side of the nose. The defect was closed with orienting the placement of the scar line in the alar crease to minimize scarring. The 8 week follow-up was excellent.
Melanoma In Situ Of The Left Cheek
This is a 77 year old female with removal of a melanoma in situ of the left cheek. Post-operative defect size was 2.5 x 2.5 cm. An advancement flap was used for closure to shorten the length of the scar. The 8 week follow-up shows mostly redness as the wound is healing but minimal scarring.
Basal Cell Carcinoma Of the Nasal Tip
This is a 65 year old male with a 1.8 x 2.0 cm Basal Cell Carcinoma of the nasal tip. Large, nasal tip defects present a MOHs Surgeon as one of the most challenging closures. An island pedicle flap was utilized in this case. This flap is created when an “island” is created as skin is completely incised on all 3 sides and the muscular flap just slides into the defect. This flap was used on his nasal tip with an excellent 8 week result.
