Facial Reconstruction & Management of Skin Cancers

“Let yourself be known by your scars…” Zulu saying

Though scars might add character to some, most of us prefer to hide and camouflage them as best possible! Facial reconstruction embraces a whole host of different problems. We might categorize reconstruction into skin problems, skeletal/fracture problems and congenital problems as our most common, though really reconstruction has a wider application for re-creating wholeness.

The management of skin cancers is often a multistage process starting from possible excision through reconstruction and sometimes into scar revision or camouflage. We perform a modified Moh’s technique for excision of skin cancers and participate in Moh’s wound defect closures for all benign and malignant skin, muscle and bony tumors. Recognizing that excision of the skin cancer is the first and primary requisite, this is done obtaining negative pathologic margins prior to the reconstruction. Frequently, just closure of a skin wound is only the first consideration. In the face, head, and neck there are so many aesthetic and functional considerations that go hand in hand with reconstruction. The range of considerations might include normalizing appearance or maintenance of a nasal airway or re-creating functional anatomy such as a well-working partnership of lips and mouth.

Reconstruction of the facial skeleton carries a different set of challenges and often has ideal time frames in which this needs to occur. Facial skeletal fractures of all varieties are part of our repertoire the more common being that of the orbit, nose and maxillofacial skeleton.

Congenital reconstruction carries with it different physical and emotional aspects. These endeavors can be so rewarding since congenital problems so frequently influence so many facets of life both for the individual and the family. We do work with a team approach for different craniofacial anomalies so that different specialities can weigh in on particular or specialized aspects of a patient’s care. We welcome in particular cleft lip and palate problems, myself specializing within the head and neck, though we work in conjunction with other specialists for overlapping problems.

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