Surgical treatment of large skin cancers

Treatment of large facial skin cancers with surgery is a multistep process. First, both the patient and the lesion must be evaluated to ensure that surgery is the most appropriate form of treatment. When surgery is deemed appropriate, the method of tumor removal must be chosen and may vary depending on the size and type of lesion. In many cases, Mohs surgery is appropriate, but in other cases, excision with en face permanent section margins will be elected. Reconstruction should only be undertaken when negative margins have been assured. Repair may entail coverage or aesthetic coverage, depending on patient factors and preferences. Flaps will generally increase cosmesis but are often not feasible once a wound reaches a certain size.