Reconstructive Methods on Different Parts of the Periocular Region after Mohs Micrographic Surgery in a Combination of Dermatologist and Facial Plastic Surgeon Practice

Objective: In the United States, the majority of post-Mohs closures around the eye are done by Mohs surgeons, who are mainly dermatologists. The objective of this study is to determine the options for closing post-Mohs defects on different parts of the periocular region that is performed by both a Mohs surgeon and facial plastic surgeon as a team. Non-melanoma skin cancer is common around the eyes and can lead to great morbidity. Mohs micrographic surgery is the treatment of choice for its resection. The resulting wound can be extensive, and the reconstruction can have great ramifications on both eyelid function, visual acuity, and esthetics. The majority of the reconstruction is handled by the Mohs surgeons. Methods: We presented 28 periocular Mohs closures that were done at a practice where a combined Mohs surgeon and facial plastic surgeon operated together in a team as opposed to individually. Results: We find that this combination provided more complex closures such as flaps and grafts, while previous publications had shown that Mohs surgeons more often close with a primary closure. Different regions of the periocular region were examined for treatment methods. The medial canthus was most often affected, and advancement flaps were most commonly used followed by full-thickness skin grafts. We did not have any cases on the upper eyelid, highlighting the sun protected characteristic of the anatomy. Conclusion: This is the first publication presenting a large number of post-Mohs closures that were reconstructed by a combined Mohs surgeon and facial plastic surgeon. The significance is that the combined skills of a Mohs surgeon and facial plastic surgeon offer a wider range of closure techniques, to the benefit of the patient