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Mohs surgery and reconstruction: What timeline to expect?

Posted by keithl56 @keithl56, May 13 6:01am

I have been diagnosed with squamous cell carcinoma on my head. My dermatologist set up a consult with a surgeon that does Moh's surgery on 5/29 and a consult with a reconstructive surgeon on 6/10.

Can anyone provide information regarding the usual time between consult and surgery and the time between Moh's and reconstruction?

I just had a large basal cell lesion surgically removed from back last May and am not looking forward to this summer!

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keithl56 | @keithl56 | May 13 9:31am
In reply to @seniormed "You may not have a realistic answer until you see the Mohs surgeon. Your derm has..." + (show)
@seniormed

You may not have a realistic answer until you see the Mohs surgeon. Your derm has followed their usual protocol assuming you need reconstructive follow up.
The Mohs surgeon deals with the size, location and extent of the squamous cell. The frozen sections they
evaluate and what they need to consider for control
of any bleeding will be a factor.The Mohs surgeon
likely has their routine established with the plastic surgeon and can communicate with pictures for planning.
Some areas on the scalp will heal with secondary intention and are suitable for gradual healing without closure.
Pathology exam will also indicate how much follow up care required.
Follow your preop instructions especially with regard to
any medication or supplements that could affect bleeding and you should do well. Understandably you are a bit apprehensive and want to plan for the best results.

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Also, I appreciate your comments regarding preop instructions and bleeding. When they surgically removed the large basal cell from my back last year they advised to stop my aspirin 10 days prior to surgery. However, my neurologist and cardiologist would only agree to a 5 day stoppage. As a result, they had to cauterize quite a bit during surgery to control the bleeding. I would think that this surgery would be more problematic since if they are going to do reconstruction they have to preserve blood flow to the area so that the flap has adequate blood flow post surgery. Definitely an issue to discuss during my consult.

REPLY
seniormed | @seniormed | May 13 8:33am

You may not have a realistic answer until you see the Mohs surgeon. Your derm has followed their usual protocol assuming you need reconstructive follow up.
The Mohs surgeon deals with the size, location and extent of the squamous cell. The frozen sections they
evaluate and what they need to consider for control
of any bleeding will be a factor.The Mohs surgeon
likely has their routine established with the plastic surgeon and can communicate with pictures for planning.
Some areas on the scalp will heal with secondary intention and are suitable for gradual healing without closure.
Pathology exam will also indicate how much follow up care required.
Follow your preop instructions especially with regard to
any medication or supplements that could affect bleeding and you should do well. Understandably you are a bit apprehensive and want to plan for the best results.

REPLY
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