Scar, Skin & Wound · Reconstruction
Mohs defect reconstruction repairs the wound left after Mohs skin cancer surgery, aiming to restore coverage, contour, and function while planning for scarring.
Is this the same as Mohs surgery?
No. Mohs surgery removes skin cancer; reconstruction repairs the remaining wound.
Repair planning follows confirmation that the cancer has been cleared. The Mohs surgeon may perform the repair or coordinate with another surgeon.
Will I need a skin graft?
Not necessarily.
Depending on the wound, options include stitches, a local tissue flap, a skin graft, or carefully supervised healing without surgical closure.
When does reconstruction happen?
Often the same day, but sometimes later or in stages.
Timing depends on cancer clearance, the wound's size and location, your health, and coordination between the surgical teams.
01 · Overview
Mohs surgery removes skin cancer in thin layers and checks each layer under a microscope. Reconstruction addresses the wound that remains; it does not replace cancer removal or ongoing skin cancer surveillance. [1]
The best repair depends on more than the wound's width. Depth, exposed cartilage or bone, nearby skin, and the position of an eyelid, nostril, or lip can all affect the plan. Preserving movement and support may be as important as appearance. [2]
A consultation before Mohs surgery can help you understand possible repairs, but the final plan may change once the full wound is known. Reconstruction leaves scars, and some wounds need more than one operation or later scar treatment. [2]
Skin cancer can extend beyond what is visible on the surface. Mohs surgery continues until the examined margins are clear, so the final wound cannot always be predicted from the original spot.
No. Mohs defect reconstruction usually repairs a fresh wound after cancer removal. Scar revision treats an existing healed scar and may be considered later if there is a specific concern.
02 · Concerns & Goals
The wound may look different from what you expected. Your surgeon can explain what was removed, which structures need support, and what repair choices fit your priorities.
A deeper wound may need tissue coverage rather than simply bringing the edges together. Your surgeon will assess the wound bed and its blood supply.
Repair near an eyelid, nose, or mouth needs to account for eye closure, breathing, or lip movement without creating too much pull.
Color, texture, thickness, and contour can differ after repair, especially with a graft. Ask which differences are likely in your location.
A flap may create incisions beyond the original wound, and a graft creates a second healing site. Some repairs intentionally involve more than one procedure.
03 · Options
These are common approaches, not interchangeable choices. Your surgeon will recommend an approach based on the cleared wound, nearby structures, and your health.
The wound edges are brought together with stitches.
Nearby tissue is moved into the wound while keeping a blood supply.
Skin from another site is transferred to cover the wound.
The wound is allowed to close gradually with supervised wound care.
More than one method may be used for a single wound. The final repair choice is made after assessing the defect and confirming cancer clearance. [1] [2].
Some flaps stay connected to their original blood supply while they heal into the repair site. A later procedure separates that connection and refines the repair. This is planned treatment, not necessarily a complication.
You can discuss scar placement, but the shortest incision is not always the safest or least noticeable repair. A longer incision may distribute tension better or protect an eyelid, nostril, or lip from distortion.
04 · Results
The first goal is a stable, healing repair that protects nearby structures.
Early swelling and scar color do not show the final result.
Repair and cancer surveillance are separate parts of your care.
Reconstruction cannot guarantee a particular appearance or prevent skin cancer from returning or developing elsewhere. [2]
05 · Recovery
Returning to work does not mean fully healed. Follow your surgeon’s instructions; strenuous activity requires clearance.
Recovery depends on the repair, body area, and whether there is a donor site or staged procedure. Your surgical team's wound-specific instructions take priority; returning to work does not mean healing is complete.
Step 1 · After cancer clearance
Your team confirms the repair plan and anesthesia. You leave with instructions for the dressing, activity limits, medications, follow-up, and whom to call.
Step 2 · First several days
Tenderness, swelling, bruising, and a small amount of drainage can occur. Dressings, graft supports, and donor sites may each need different care.
Step 3 · Following days to weeks
Visits assess healing and blood supply and address stitches or special dressings when appropriate. Open wounds or staged flaps may need longer follow-up.
Step 4 · Following months
Scar color, firmness, and contour gradually change. Your surgeon can advise when scar care or any further treatment is appropriate.
Ask your surgical team whether compresses are appropriate and exactly how to use them.
Not unless your team tells you to. Some dressings hold the graft still against its blood supply. Call if the dressing loosens, becomes soaked, or causes unexpected discomfort.
Ask your surgeon after the wound has closed and been assessed. Silicone products, massage, and other scar treatments are not appropriate for every wound or stage of healing.
06 · Safety
Some soreness, swelling, bruising, redness, and temporary numbness can occur. Your team should explain what is expected for your repair and which changes need prompt attention.
Bleeding beneath a repair can cause pressure and interfere with healing, sometimes requiring treatment.
Infection can delay healing and may require medication or another procedure.
The wound may open or heal slowly, particularly when circulation is poor or tension is high.
Transferred tissue may not receive enough blood supply. Partial or complete loss can require more wound care or surgery.
Scars may widen, thicken, contract, or remain noticeable. Contour changes or pulling on nearby structures may affect appearance or function.
Numbness, persistent discomfort, or nerve injury can occur. Local anesthesia, sedation, and general anesthesia each have risks that should be discussed.
Discuss these risks and your individual health history with your surgeon. [2]
07 · Costs
Compare written estimates for the same planned scope, including the reconstruction method, anesthesia setting, follow-up, and any staged procedures. Mohs cancer removal and reconstruction may be billed separately.
Surgeon
Evaluation, reconstruction, and any planned surgical stages.
Ask your surgeonAsk which clinicians bill separately and whether later revision is included.
Facility
Anesthesia services and use of an office procedure room, surgery center, or hospital.
Ask your surgeonConfirm the setting, anesthesia plan, network status, and separate facility charges.
Supplies
Dressings, wound-care supplies, medications, and postoperative visits.
Ask your surgeonAsk what is included and how additional wound care or complications are billed.
TRC
Any separately offered scheduling, care-coordination, or administrative support.
Ask TRCAsk whether these services carry a fee, what they include, and whether they are optional.
Your written estimate should explain the services included, any separate charges, and payment terms.
08 · Questions
Reconstruction after skin cancer removal may be covered, but benefits, medical necessity requirements, network status, and authorization rules vary. Confirm coverage for each clinician and facility before treatment when possible.
Reconstruction does not replace surveillance. Tell your dermatologist about a new lump, persistent sore, bleeding, or another change in or near the scar, and keep scheduled skin checks.
Yes. A skin graft creates a second healing site, and that site can leave a scar or color change. Ask where skin would be taken and how that area will be cared for.
Often, yes, especially when a complex repair is anticipated. The consultation can cover possible approaches, but the final choice depends on the wound after cancer removal.
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