Face
Mohs Reconstruction
Expert reconstruction following Mohs surgery for skin cancer — restoring both function and appearance with the precision of a craniofacial-trained plastic surgeon.
About Mohs Reconstruction
Mohs micrographic surgery is the gold standard for removing certain types of skin cancer, particularly on the face. While Mohs surgery achieves excellent cancer clearance, it can leave defects of varying size and complexity that require skilled reconstruction to restore both function and aesthetics.
Dr. Lemelman works closely with Mohs surgeons to provide seamless reconstructive care. His craniofacial training gives him expertise in the complex anatomy of the face — including the eyelids, nose, lips, ears, and scalp — allowing him to choose the optimal reconstructive technique for each defect.
Reconstruction may involve primary closure, local tissue rearrangement (flaps), skin grafts, or a combination of techniques. The goal is always to restore normal appearance and function while minimizing visible scarring. Most repairs can be performed in the office under local anesthesia only, this allows for faster recovery and eliminates side effects of general anesthesia.
Benefits
- Restores appearance after skin cancer removal
- Preserves and restores facial function
- Minimizes visible scarring with advanced techniques
- Expert care for complex facial defects
- Craniofacial-trained surgeon for optimal outcomes
- Coordinated care with your Mohs surgeon
- Addresses eyelids, nose, lips, ears, and scalp
- Same-day or next-day reconstruction available
Why Choose a Plastic Surgeon for Mohs Reconstruction?
Not all surgeons who perform Mohs surgery also specialize in reconstruction. Dermatologic surgeons excel at cancer clearance — but complex facial reconstruction, particularly around the nose, eyelids, lips, and ears, requires the advanced training of a board-certified plastic surgeon.
Dr. Lemelman completed fellowship training in craniofacial surgery, giving him a deep understanding of facial anatomy, tissue movement, and the biomechanics of flap design. This training is directly applicable to Mohs reconstruction, where the surgeon must choose from dozens of possible techniques and execute them with precision to achieve a natural result.
Patients who see Dr. Lemelman for Mohs reconstruction benefit from a surgeon who thinks about the long-term aesthetic outcome from the first incision — not just wound closure. The difference is most visible in complex areas like the nasal tip, the eyelid margin, and the vermilion border of the lip, where millimeters matter.
Reconstruction by Location
Nose
The nose is the most common site for skin cancer and one of the most technically demanding areas to reconstruct. Dr. Lemelman uses nasolabial flaps, paramedian forehead flaps, and composite grafts to restore nasal contour, tip projection, and airway patency after Mohs excision.
Eyelid
Eyelid reconstruction requires precise restoration of both the structural and functional layers — skin, muscle, and the tarsal plate — to protect the eye and preserve normal blinking. Dr. Lemelman's oculoplastic training makes him uniquely qualified to address upper and lower eyelid defects of any size.
Ear
Ear reconstruction after Mohs surgery addresses defects of the helix, antihelix, lobule, and conchal bowl. Techniques range from primary closure and skin grafts for smaller defects to local flaps and cartilage grafts for larger or full-thickness losses.
Lip
Lip reconstruction must restore the vermilion border, oral competence, and natural movement. Dr. Lemelman uses Abbe flaps, Karapandzic flaps, and local advancement techniques to achieve natural-appearing results while preserving speech and eating function.
Scalp
Scalp defects following Mohs surgery can range from small closures to large areas requiring tissue expansion or free flap reconstruction. Dr. Lemelman tailors the approach to defect size, hair-bearing status, and the patient's overall health.
Recovery & What to Expect
Procedure time
1–4 hours (varies by defect)
Anesthesia
Local
Return to work
1–3 weeks
Sutures removed
5–14 days
Scar maturation
12–18 months
Follow-up
Coordinated with Mohs team
Frequently Asked Questions
When should reconstruction happen after Mohs surgery?
Reconstruction is typically performed the same day as Mohs surgery, once the margins are confirmed clear. In some cases — particularly for larger or more complex defects — reconstruction may be scheduled for the following day to allow for careful planning.
What reconstruction technique will be used?
The technique depends on the size, location, and depth of the defect. Options include primary closure (direct stitching), local flaps (rearranging nearby tissue), and skin grafts. Dr. Lemelman selects the approach that will achieve the best functional and aesthetic outcome for your specific defect.
Will I have a visible scar?
Some scarring is inevitable after any surgery, but Dr. Lemelman uses advanced techniques to minimize visibility. Scars on the face typically mature and fade significantly over 12–18 months. Scar revision or laser treatment can be considered later if needed.
Is reconstruction covered by insurance?
Yes — reconstruction following Mohs surgery for skin cancer is a medically necessary procedure and is covered by most insurance plans, including Medicare. Dr. Lemelman's office will work with your insurance to obtain prior authorization before surgery.
Do I need a referral from my Mohs surgeon?
A referral is helpful but not always required. Dr. Lemelman works closely with dermatologic surgeons throughout Chicago and welcomes direct consultations. If you have already had Mohs surgery and need reconstruction, contact the office to schedule an urgent evaluation.
Can nose reconstruction after Mohs surgery look natural?
Yes. Nasal reconstruction is one of Dr. Lemelman's areas of expertise. Using techniques such as the paramedian forehead flap and nasolabial flap, he can restore the nose's shape, contour, and projection to closely match the surrounding tissue. Results continue to improve as swelling resolves over 6–12 months.
What happens if the Mohs defect is near my eye?
Eyelid and periorbital reconstruction requires specialized training to protect vision and restore normal eyelid function. Dr. Lemelman's craniofacial background includes eyelid reconstruction — he will assess the depth and extent of the defect and choose a technique that restores both appearance and the protective function of the eyelid.
How is ear reconstruction performed after Mohs surgery?
Ear reconstruction depends on which part of the ear is affected and how much tissue was removed. Small defects of the helix or lobule can often be closed directly or with a skin graft. Larger defects involving cartilage may require local flaps or cartilage grafts to restore the ear's three-dimensional shape.
Can lip function be preserved after Mohs reconstruction?
Yes — preserving oral competence (the ability to close the lips fully) and natural movement is a primary goal of lip reconstruction. Dr. Lemelman uses flap techniques that recruit adjacent tissue while maintaining the muscular function needed for speech, eating, and expression.
How long does recovery take after Mohs reconstruction?
Most patients return to light activity within 1–2 weeks. Sutures are typically removed at 5–14 days depending on location. Swelling and bruising resolve over 2–4 weeks, and scars continue to mature and soften over 12–18 months. Dr. Lemelman will provide a detailed recovery plan tailored to your specific reconstruction.
Ready to take the next step?
Every journey begins with a conversation. Book your personal consultation with Dr. Lemelman directly.