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Expansion techniques after Mohs' surgery on the face.

D J Hodgkinson¹, Q Lam

¹Skin and Cancer Foundation, Sydney, New South Wales, Australia. Dr-hodgkinson@bigpond.com

The Australasian Journal of Dermatology

|March 10, 2001

Summary

Mohs surgery effectively treats facial skin cancers. For large defects, skin expansion techniques provide ample tissue for reconstruction, ensuring optimal cosmetic outcomes.

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Area of Science:

Dermatologic Surgery
Plastic and Reconstructive Surgery

Background:

Mohs surgery is the gold standard for treating facial basal cell and squamous cell carcinomas, achieving high cure rates.
Reconstruction of defects after Mohs surgery, especially extensive ones, is crucial for achieving favorable cosmetic results.

Observation:

While flap reconstruction suits smaller defects, larger defects often necessitate tissue expansion techniques.
Tissue expansion involves surgically placing a silastic expander under adjacent skin, gradually inflating it with saline over weeks to generate excess skin.

Findings:

This two-stage procedure involves expander insertion followed by its removal and use for flap reconstruction once sufficient tissue is achieved.
Expansion techniques are recommended for defects exceeding half of a facial aesthetic unit, one-third of the forehead, or 6 cm on the scalp.

Implications:

Skin expansion is a valuable reconstructive option for complex facial defects following Mohs surgery.
This technique enhances the ability to restore both function and form after oncologic resection.
Careful planning of reconstruction is essential for maximizing aesthetic outcomes in challenging cases.

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