Nose Reconstruction After Skin Cancer
Reconstruction is an integral part of the treatment plan for skin cancer of the nose. After skin cancer has been diagnosed, the cancerous areas must be removed as soon as possible to prevent any further spread of the cancer and increase the likelihood of a full recovery. In most cases, the excision of the affected skin results in an open wound that must be addressed by a plastic surgeon to avoid scarring or disfigurement. When skin cancer occurs on the nose, reconstruction can be especially challenging, as the surgeon will be treating a three dimensional area that may require the replacement of skin, bone, cartilage, and other soft tissues. In order to regain a normal appearance after Mohs surgery, it is important to work with a plastic surgeon who is highly experienced in reconstructive surgery of the face and nose. Once the dermatologist refers the patient to the best rhinoplasty surgeon in the area, the doctors will create a comprehensive plan to remove the cancer and reconstruct the nose.
In New York, many skin cancer patients are referred to Dr. Rizk for reconstruction after a Mohs excision. Mohs surgery is the most frequently used technique to excise skin cancer. The technique allows the dermatologist to preserve as much normal tissue as possible, while ensuring that the entire cancerous region has been removed. During the excision, the dermatologist will remove the tumor and some of the surrounding skin, which he will then examine microscopically to ensure he has removed all of the cancerous tissue. He will continue to remove skin from the area until he is sure that the cancer has been completely eliminated. Once the excision has been completed, the patient will be sent to Dr. Rizk for reconstruction. When performing nasal reconstruction, Dr. Rizk prefers to coordinate with the dermatologist ahead of time so that the patient can undergo reconstruction on the same day as the Mohs surgery, which will provide the best results.
Reconstruction following Mohs surgery may require more than one procedure. The primary reconstruction will address the open wound and any underlying structural issues. The first choice for covering the surgical wound is the use of a localized tissue flap. In this case, the flap is usually created from local tissue and then rotated onto the wound. This approach is preferred because there is little risk of rejection, as the patient’s own tissue is used. In cases where cartilage has been removed during Mohs surgery, the surgeon may need to create a composite graft of skin and cartilage to build up the nose and cover the wound. In this case, the skin and cartilage are typically harvested from the patient’s ear. A year after the initial reconstruction, patients may opt to undergo further treatment to refine and perfect their nose. If visible scarring or thick scar tissue is present in the reconstructed area, laser resurfacing or dermabrasian can be performed to improve the texture and appearance of the skin. In other cases, rhinoplasty may be performed to remove internal scar tissue that is causing breathing difficulties or cosmetic disfigurement.
Reconstructive nose surgery is incredibly challenging and requires the skill of a highly experienced doctor. Our doctor spent four years of his surgical training focusing on reconstruction of the nose and face following cancer removal. Currently, about 10 -15% of patients in his Manhattan practice are reconstructive cases following skin cancer or trauma to the face and nose. He is well qualified to perform nasal reconstruction after skin cancer removal and has worked with many dermatologists through NYC to treat cancer patients. If you have been diagnosed with nasal skin cancer, please contact our office today to discuss reconstruction with Dr. Rizk.
Nose Reconstruction After Skin Cancer FAQs
Why is nose reconstruction necessary after skin cancer treatment?
Mohs surgery is the most common treatment for skin cancer. Typically performed by a dermatologist, this procedure involves the removal of the tumor and a small area of skin surrounding it. After excision, the dermatologist will immediately examine the excised skin microscopically to ensure that the cancer has been completely removed. While this technique helps preserve as much normal tissue as possible, there will be an open wound that must be addressed. When skin cancer occurs on the nose, your dermatologist may suggest that you work with a nose surgeon to repair the area. Because the nose is such a prominent feature on the face, great care must be taken to ensure that scarring does not occur and that the nose will retain its original appearance. Patients undergoing Mohs surgery in New York or New Jersey may choose to work with our doctor to repair their nose after skin cancer treatment.
When can nasal reconstruction be performed?
Our doctor recommends that you plan to undergo nasal reconstruction immediately after Mohs surgery, preferably on the same day. The dermatologist and plastic surgeon should coordinate their efforts to achieve the best cosmetic results.
How is nasal reconstruction performed after Mohs surgery?
After the skin cancer has been removed, our doctor will examine your nose and plan the reconstruction. The techniques he uses will depend upon the amount of skin that has been excised and its location on the nose. In all cases, the repair will involve some type of skin graft to cover and close the open wound. Our doctor may take tissue from the surrounding facial areas or even the nose itself, in which case the skin will be rotated over the wound. In some cases, cartilage is also removed during Mohs surgery. In these situations, our doctor must build up the area to restore its original shape and contour. In most cases, the cartilage that is used is taken from the patient’s ear.
Is nasal reconstruction a difficult procedure to perform?
Many surgeons consider nasal reconstruction to be one of the most challenging types of plastic surgery to perform. The nose is not only an important aesthetic feature of the face, but it also plays a critical part in breathing and the sense of taste and smell. Unlike other parts of the body that are affected by skin cancer, such as the cheeks and forehead, the nose is a three dimensional structure, made upon of skin, bone, and cartilage. This makes excision and reconstruction more challenging than it would be on other areas of the body.
Who should perform nose reconstruction?
It is important to work with a doctor who has specific training in nasal reconstruction following Mohs surgery. Located in NYC, Dr. Rizk is a double board certified facial plastic and reconstructive surgeon who spent 4 years of his surgical training focusing on nasal and facial reconstruction following skin cancer treatment. Currently, 10 to 15% of the surgeries he performs are on patients following skin cancer removal or other trauma to the face and nose. This makes him one of the most qualified surgeons to perform nasal reconstruction in the NYC and NJ area. If you will be undergoing nasal skin cancer treatment, please contact us today to set up a consultation to discuss nasal reconstruction.
By Dr. Sam S. Rizk, M.D., FACS.
Dr. Rizk is a double board-certified facial plastic surgeon who specializes in rhinoplasty surgery and a recognized expert on the latest advances in facial plastic surgery techniques. He performs a range of facial plastic surgeries at his New York practice.