The Piazza Center for Plastic Surgery and Advanced Skin Care
7900 Farm to Market Road 1826, Bldg 2, Suite 206
Austin, TX 78737
Phone: (512) 288-8200
Monday–Thursday: 9 a.m.–3 p.m.
Friday: 9 a.m.–2 p.m.
Skin Cancer Reconstruction
Mohs micrographic surgery (MMS) is a state-of-the-art technique for the treatment of skin cancer on the face. This is a delicate and extensive process designed to remove cancerous skin cells while leaving all healthy tissue intact. Mohs surgery is performed by highly trained dermatologists who specialize in skin cancer removal. Once the procedure is finished, it often leaves the patient with large, gaping wounds requiring a plastic surgeon’s expertise for repair. Dr. Marcelo Antunes is a double board-certified facial plastic surgeon with a reputation for achieving excellent facial skin cancer reconstruction results for patients from Austin, San Antonio, and surrounding areas. He works with several dermatologists and Mohs surgeons in central Texas and uses advanced surgical techniques that minimize scar tissue formation and recovery times.
Meet Dr. Antunes
Board-certified facial plastic surgeon Dr. Marcelo Antunes dedicates his practice exclusively to aesthetic procedures for the face. He can help you look your best and be confident in your appearance.About Dr. Antunes
How Does Mohs Surgery Work?
Mohs surgery has the highest cure rates for treating all skin cancers. It is especially valuable for certain areas of the face where preserving the most amount of healthy skin becomes crucial. Mohs surgery is ideal for the treatment of cosmetically important areas, which commonly include the:
Mohs surgery is the standard of care for removing basal cell carcinomas, squamous cell carcinomas, and other skin lesions on the face—it offers the lowest recurrence rate for malignant lesions.
During Mohs surgery, the skin cancer area is removed with a small margin around it. This small layer of skin is meticulously removed and examined under a microscope for cancerous cells. The Mohs surgeon will thoroughly examine all the edges of the removed skin to determine if there are any cancerous cells. If there is any evidence of the skin cancer extending into the margins of the excision, thin layers of skin are then removed and examined in an incremental manner so all the skin cancer is removed while the maximum amount of normal skin is spared.
What Happens After Mohs Surgery?
Removing the skin cancer with Mohs surgery leaves a depression or hole in the skin, which may be comprised of:
- Skin only
- Skin and fat
- Skin, fat, and muscle
- Skin, fat, muscle, and cartilage/bone
Typically, these skin defects are rather disfiguring. Reconstructive surgery may be performed immediately after Mohs surgery to repair the damaged site. Dr. Antunes specializes in carefully reconstructing the facial tissue by restoring its natural appearance while preserving the form and function of important structures of the face. Dr. Antunes works closely with several Mohs surgeons in Austin and Central Texas. His goal is to create a seamless transition from skin cancer excision to reconstruction so that patients are well cared for throughout this often stressful process.
Am I a Candidate for Skin Cancer Reconstruction?
Most patients that are submitted to skin cancer removal through Mohs surgery will be a candidate for reconstruction. On rare occasions, there will be an option of allowing the wound to heal on its own (by secondary intention).
The majority of times, patients will benefit from having the skin defect resulting from the removal of skin cancer repaired. This procedure can be done either by the Mohs surgeon or by a facial plastic surgeon depending on the following:
- Location of the skin cancer
- Extent and depth of the skin defect
- Patient preference
This decision usually involves a discussion between the patient and the dermatologist/Mohs surgeon.
Even when the skin cancer lesion appears very small, the skin defect resulting from its removal can end up being quite large. Many Mohs surgeons are able to anticipate the need for a reconstructive specialist prior to removal of the skin cancer. You will have a formal consultation with us before your procedure if your cancer is located on any of the following areas:
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Find out what it's like to be a patient of The Piazza Center. Review the stories and "after" photos of some of the plastic surgery patients who've shared their experiences with us.View Stories
The procedure is separated into two parts: the removal of the skin cancer at the Mohs Surgeon’s office and the repair at our office. The length of the removal portion of the procedure will depend on how many layers the Mohs surgeon needs to perform in order to fully remove all the skin cancer. After your Mohs surgery is complete, you will have a bandage placed over the wound and be directed to our office. We strive to offer same-day service. At that point, Dr. Antues will assess the skin defect and discuss all options for reconstruction in detail.
Most skin defects can be repaired with skin flaps or skin grafts. A skin flap utilizes a piece of skin adjacent to the area of skin that was removed. A skin graft involves removing a piece of skin from a donor site (e.g., the back of the ear or above the clavicle) and then stitching it into the skin defect. On occasion, the skin defect will require a more involved reconstruction process such as structural support or a multiple-staged reconstruction process depending on the following:
- Location of the skin defect
- Amount of tissue that was removed
- Whether other tissue such as cartilage and bone must be reconstructed as well
Dr. Antunes specializes in these complex reconstructions. Most reconstructive procedures can be performed using local anesthetic or sedation. Dr. Antunes is very experienced in reconstructive surgery using a local anesthetic; thus patients frequently can avoid going to the operating room or surgery center.
Recovery & Results
Patients go home the day of surgery and are cared for by a loved one. Dr. Antunes removes the bandage the day after the surgery and all sutures a week after surgery.
Recovery after skin cancer reconstruction can range from a few days to a few weeks, depending largely on how the skin defect is repaired. Patients should avoid strenuous physical activity for 2 weeks. Most patients do not experience much pain after surgery but may notice discomfort from the swelling and bruising. Depending on your type of work and the extent of your procedure, you may return to your regular activities as early as 7 days after surgery.
Follow-up appointments are scheduled during the first 3 months after the surgery so Dr. Antunes can closely monitor your progress. His primary objective is to provide a safe, comfortable surgical experience that produces the results you desire and makes you happy.
You can expect to be 75% healed by 6 to 8 weeks after the surgery and 100% healed after 6 months.
Dr. Antunes has dedicated himself to the mastery of procedures for the face and nose. He is widely considered one of the top facial plastic surgery specialists in Austin, TX, and the entire region. He uses advanced, proven techniques and exceptional training and skill to create beautiful, natural-looking results for his patients. If you would like to find out more about skin cancer reconstruction for the face, request an in-person or virtual consultation using the online form or call our office at (512) 288-8200.