Anesthesia is given. Skin cancer reconstruction may be performed under local anesthesia, intravenous sedation (also known as managed anesthesia care (MAC) or “twilight sleep”), or general anesthesia. Your doctor will recommend the best choice for you, based on what tends to work well for the procedure you are having, as well as any other medical conditions you may have. If your plastic surgeon is the one excising the lesion, it will be done at this stage. A small lesion with well-defined borders may be removed with a simpler surgical process called excision.
The lesion is removed. This step may have already been completed in a separate procedure unless your plastic surgeon is also the one removing your lesion or is working with your dermatological surgeon as a team in a single procedure. Note: If your lesion was small with well-defined borders, a simple surgical process called excision may have been used to remove it. If it was larger without well-defined borders, Mohs surgery was probably required.
The wound is closed. If your procedure has been a simple excision, this is a relatively straightforward process. If, however, more complex Mohs surgery was required, there are a number of options to repair the resulting defect left behind after removal of the lesion.
Regardless of the techniques used, your plastic surgeon will take care whenever possible to ensure that the resulting suture line is positioned to follow the natural creases and curves of your face, in order to minimize the appearance of your scar.
After surgery. You will be observed for awhile after your surgery has been completed, and then given instructions for returning home. Some people, especially those who have a flap procedure, may be given a prescription for antibiotics to take at home. It is important to talk to your surgeon about symptoms of infection and when to call. Most often your surgeon will ask you to call if you develop a fever over 101F, increasing redness, pain, or discharge.
If you’re given antibiotics to take, make sure to finish all of these. One of the most important things you can do to reduce your chance of infection is to refrain from smoking, as smoking interferes with healing after plastic surgery.