Is this the same as Mohs surgery?
No. Mohs is a specific method of removing skin cancer with staged microscopic margin checks.
Reconstruction may follow Mohs or a standard surgical excision. The removal method depends on the cancer and its location.
Reconstructive Surgery
Skin Cancer Excision with Reconstruction
Skin cancer excision with reconstruction removes cancerous skin and repairs the resulting wound while aiming to preserve function and appearance.
Will the wound be repaired right away?
Sometimes, but repair may wait until the team confirms that the cancer has been adequately removed.
The timing depends on how margins are examined, the wound, and the planned reconstruction.
Will there be a scar?
Surgery leaves a scar, even when reconstruction helps restore contour and function.
Scar placement, wound size, skin characteristics, and healing all affect its eventual appearance.
01 · Overview
Removing the cancer, then repairing the wound
Excision removes the skin cancer and a planned border of surrounding tissue. The tissue is examined to assess the diagnosis and margins—the edges of the removed specimen. Cancer type, depth, and location help determine the treatment plan. [1]
Reconstruction repairs the opening left after removal. A surgeon may bring the edges together, move nearby tissue into the wound, or use a skin graft from another area. Some wounds are better managed with dressings while they heal without surgical closure. [2]
This is not simply cosmetic scar revision, and reconstruction does not replace cancer treatment. Your surgeon balances adequate cancer removal with protection of nearby structures, movement, contour, and appearance. Continued skin cancer follow-up remains important after the wound heals. [1]
- Primary goal
- Cancer removal followed by wound repair
- Anesthesia
- Local anesthesia, sometimes with sedation or general anesthesia
- Care setting
- Office, outpatient surgical center, or hospital
- Recovery
- Varies with wound location, size, and repair method
What does a clear margin mean?
It means cancer cells were not found at the examined edges of the removed tissue. It helps guide treatment but does not guarantee that cancer cannot return. If margins contain cancer, further removal or another treatment may be needed.
Who performs each part?
A dermatologist, Mohs surgeon, plastic surgeon, or another cancer surgeon may be involved. Sometimes one clinician handles removal and repair; sometimes specialists coordinate them. Ask who will communicate pathology results and direct follow-up.
02 · Concerns & Goals
What you may want to discuss
A skin cancer diagnosis can bring questions about treatment, scarring, and daily life. Your care team can help you understand both cancer removal and reconstruction.
Confidence in cancer removal
You may want to know how the edges will be checked and what happens if additional cancer is found.
Protecting everyday function
A wound near an eyelid, nose, lip, ear, or joint may affect movement or nearby structures. Repair planning considers these needs.
A visible scar or contour change
The final wound may be larger than the visible skin spot. Ask about likely scar placement, changes in shape, and any donor-site scar.
Managing treatment and recovery
Dressings, follow-up visits, activity limits, and possible staged surgery can affect work and caregiving. Discuss support needs before treatment.
03 · Options
How the approaches differ
The repair is chosen for the wound remaining after cancer removal—not just the original spot. Your surgeon may need to adjust the plan once its full size and depth are known.
Direct closure
The wound edges are brought together with stitches.
How it worksThe surgeon may loosen nearby skin to close the opening without excessive tension.
May suitSelected wounds with enough surrounding skin and a safe closure direction.
Main tradeoffThe scar may be longer than the original spot, and tight closure can distort nearby features.
Local flap
Nearby skin and supporting tissue are moved into the wound.
How it worksThe tissue keeps a blood supply while it is advanced, rotated, or repositioned.
May suitWounds needing coverage with nearby tissue of similar color, thickness, or texture.
Main tradeoffAdditional incisions are needed, and blood-supply problems or contour differences can occur.
Skin graft
Skin from another area covers the wound.
How it worksThe graft is secured over a suitable wound bed and must develop a blood supply from it.
May suitSelected wounds where direct closure or a nearby flap is not the best fit.
Main tradeoffA second site must heal, and the graft may differ in color, texture, or contour.
Staged or more complex reconstruction
Repair is completed through multiple steps or with additional tissue support.
How it worksA planned flap may need a later procedure, or deeper defects may require cartilage or other tissue reconstruction.
May suitSelected larger or deeper wounds, particularly where structural support or specialized coverage is needed.
Main tradeoffTreatment may involve more than one operation, longer follow-up, and additional donor-site healing.
Cancer clearance takes priority over the closure method. Flaps and grafts have different healing needs, and a more complex repair is not automatically a better choice. [1] [2].
Can I choose my repair before removal?
You can discuss preferences and likely options beforehand. The final choice may depend on the actual wound, margin findings, tissue blood supply, and your health.
Why might reconstruction be delayed?
The team may need final pathology results, further removal, or additional planning. If repair is delayed, you should receive a specific wound-care plan and a clear follow-up arrangement.
04 · Results
What may improve and what may remain
Cancer treatment and repair are separate goals
A well-healed repair does not by itself confirm cancer clearance.
- Pathology findings and the cancer treatment plan guide whether further care is needed.
- Ask when results will be available and who will explain them.
Function and contour may improve
Reconstruction aims to cover the wound and protect nearby structures.
- The achievable shape and movement depend on how much tissue was removed and where.
- Some tightness, numbness, asymmetry, or contour change may persist.
Scars continue to change
Early appearance is not the final appearance.
- Redness, firmness, and swelling can settle over months.
- A graft may remain a different shade or texture from nearby skin.
- Scar treatment or revision may be discussed after healing, if appropriate.
Reconstruction cannot guarantee a particular appearance or prevent cancer recurrence. Ongoing skin examinations and the recommended cancer follow-up remain important. [2]
05 · Recovery
Planning your recovery
Recovery at a glance
- Stay after surgery
- Determined by Your Surgeon
- Initial recovery at home
- Varies by Individual
- Return to desk work
- Varies by Procedure and Work Activity
- Light daily activities
- Based on Individual Recovery
- Strenuous exercise
- Based on Surgeon Clearance
Returning to work does not mean fully healed. Follow your surgeon’s instructions; strenuous activity requires clearance.
Recovery depends on the location and depth of the wound, the repair, and your health. A small stitched closure and a complex flap can require very different care. Follow your surgical team's individualized instructions.
Step 1 · Day of surgery
Treatment day
The team explains the closure, dressings, pain plan, and any donor-site care. If sedation or general anesthesia is used, arrange transportation and support as directed.
Step 2 · First several days
Early wound protection
Soreness, bruising, swelling, and a small amount of drainage may occur. A flap or graft may need special protection and early checks of its blood supply.
Step 3 · Following days to weeks
Follow-up and increasing activity
Visits may include dressing changes, stitch removal, and review of pathology. Activity increases according to wound stability and the repair—not just how comfortable you feel.
Step 4 · Following months and beyond
Scar maturation and surveillance
Scars soften and change gradually. Your team can advise on scar care once the wound is ready, while skin cancer surveillance continues on a separate schedule.
Planning everyday activities
ActivityGeneral planning contextWhat affects the plan
Work and usual routinesPlanning context: Some people resume light routines within days; others need longer or staged treatment.What affects it: Wound location, dressings, job demands, and anesthesia affect timing. Returning to work does not mean complete healing.
Exercise and liftingPlanning context: Straining or stretching may need to be limited until the repair is secure. [3]What affects it: Bleeding risk, tension on stitches, and flap or graft protection guide clearance.
Bathing and swimmingPlanning context: Ask when the area may get wet and when soaking is safe. [3]What affects it: Dressings, open areas, and donor-site healing may require different instructions.
Sun exposurePlanning context: Discuss sun protection for both healing skin and long-term skin health. [1]What affects it: Your team can explain when products may be applied to the repair and how to protect it before then.
Get instructions for your specific repair and each donor site. Ask your surgical team whether compresses are appropriate and exactly how to use them.
Before your procedure
- Confirm the diagnosis, treatment site, and which clinician will remove the cancer.
- Ask how margins will be checked and whether reconstruction may be delayed.
- Review all medicines and supplements; do not stop prescribed medicines without guidance.
- Discuss nicotine use, diabetes, circulation problems, and any previous radiation or wound-healing difficulties.
- Arrange transportation, home support, and work adjustments based on the planned anesthesia and repair.
- Obtain written instructions for preparation, wound care, follow-up, and after-hours contact.
Will I need help with dressings?
Possibly, especially if the wound is difficult to reach or there is a donor site. Ask the team to demonstrate care and explain which dressings must stay undisturbed.
When can I start scar treatment?
Only when your surgeon confirms the wound is ready. Silicone products, massage, and other treatments are not appropriate for every repair or at every stage.
06 · Safety
Risks and what your clinician assesses
Temporary soreness, swelling, bruising, tightness, and altered sensation can occur. Your team should explain what is expected for your repair and which changes need prompt attention.
Bleeding or a blood collection
Bleeding beneath the repair can cause pressure, disrupt healing, and sometimes require treatment.
Infection
An infection may need antibiotics, drainage, or changes to wound care.
Delayed healing or wound separation
The wound or donor site may heal slowly or reopen, requiring longer care or another procedure.
Flap or graft loss
Insufficient blood supply can cause part or all of transferred tissue to fail, sometimes requiring further reconstruction.
Scarring, sensation, or functional changes
Raised scars, color differences, numbness, contour changes, or pulling on nearby structures may persist.
Anesthesia or medication complications
Reactions and other complications depend on the medicines used, the procedure, and your health. Discuss your individual risks before treatment.
Discuss these risks and your individual health history with your surgeon. [2]
What your clinician assesses
- Cancer type, location, depth, margin status, and need for additional treatment
- Wound size, nearby structures, available tissue, and local blood supply
- Health conditions, nicotine use, prior radiation, and healing history
- Medicines, allergies, anesthesia history, and ability to manage recovery
07 · Costs
What makes up the Total Procedure & Care Cost
Compare written estimates for the same planned scope: cancer removal, margin testing, reconstruction, and any expected stages. Ask which clinicians and facilities will bill separately and how a change in the repair could affect charges.
Surgeon
Surgical care
Cancer removal and reconstruction may involve separate clinicians and procedure charges.
Ask your surgeonAsk whether pathology, additional removal, and planned later stages are included or billed separately.
Facility
Anesthesia and facility
Charges may depend on the care setting and whether local anesthesia, sedation, or general anesthesia is used.
Ask your surgeonConfirm separate professional and facility fees and each provider's insurance network status.
Supplies
Supplies and follow-up
Dressings, medicines, donor-site supplies, and postoperative visits may carry separate costs.
Ask your surgeonAsk what routine follow-up includes and how unplanned wound care or revision would be billed.
TRC
Patient Services
Care coordination or administrative support may be listed separately if offered.
Ask TRCAsk what each service provides, whether it is optional, and whether any fee is separate from clinical care.
Your written estimate should explain the services included, any separate charges, and payment terms.
08 · Questions
Common questions
Does reconstruction mean the cancer is cured?
No. Reconstruction repairs the wound. Pathology, cancer type and stage, and follow-up determine whether more cancer treatment is needed.
Can the repair hide a recurrence?
A repaired area still needs monitoring. Tell your clinician about a new lump, sore, bleeding area, or other change in or near the scar, and keep scheduled skin examinations.
Will insurance cover the procedure?
Cancer removal and medically necessary reconstruction may be covered, but benefits, authorization, network rules, and out-of-pocket costs vary. Confirm coverage for each part of care with your insurer.
Can I avoid a skin graft?
Sometimes another repair is suitable, but a graft may be the safest or most practical choice for a particular wound. Discuss your preferences while leaving room for findings after cancer removal.
0 consultation questions in your plan
View in My TRC workspaceMy Aesthetic Plan
Prepare for your consultation
Bring these to help your consultation:
- Confirm the removal method, margin-checking plan, and reconstruction timing.
- Arrange personalized wound-care instructions, support, and follow-up contacts.
- Review written costs, insurance requirements, and the ongoing cancer surveillance plan.
View My Aesthetic Plan
Choices stay in this visit until saving to your account completes. Nothing is sent to a clinician.
Sources
- [1]Mayo Clinic: Skin cancer—Diagnosis and treatmentSkin cancer excision, Mohs surgery, treatment selection, alternative cancer treatments, and sun protection.
- [2]American Society of Plastic Surgeons: Skin Cancer RemovalReconstruction after skin cancer removal, local flaps and skin grafts, surgical risks, scarring, recovery, and the need for continued monitoring.
- [3]MedlinePlus: Skin flaps and grafts—self-careIndividualized flap and graft wound care, activity and bathing precautions, and warning signs including infection, bleeding, wound separation, and tissue color changes.
Photographs are illustrative scenes, not patients, staff, facilities or outcomes. This information does not replace a personal assessment by your treating clinician.