Facial reconstruction entails repairing a defect or injury due to trauma, cancer, or scar. Many of Dr. McClellan's surgery are repairs after Moh's micrographic surgery. This is a specialized dermatology practice that Dr. McClellan works closely with in order to provide the best care for his patients.
Additionally facial trauma from falls or cuts often need emergency repair in the operating room depending on the severity of the laceration. Please read through some information and videos below to see the various surgeries that Dr. McClellan performs.
What is a Facial Reconstruction after Moh's?
Mohs surgery is a procedure used to treat skin cancer. This surgery involves cutting away thin layers of skin. Each thin layer is looked at closely for signs of cancer. The process keeps going until there are no signs of cancer. These cancers can be Basal Cell and Squamous Cell Carcinoma.
The goal of Mohs surgery is to remove all of the skin cancer without hurting the healthy skin around it. Mohs surgery allows the dematologist to be sure that all the cancer is gone. This makes it more likely that the cancer is cured. It reduces the need for other treatments or more surgery.
Following Moh's surgery the defect may be larger or more complex than the dermatologist, who takes off the cancer, is comfortable repairing. Its at this time that Dr. McClellan get involved and typically repairs these defects in the operating room.
What is a Skin Graft?
A skin graft in one of the ways in which Dr. McClellan can repair defects on the nose. Its critical that there is good blood supply to the tissue that is remaining after resection. If there is not a good vascularized bed on which to set the skin graft than Dr. McClellan might need to close the defect in a more complex way called a "Flap".
Click the picture watch a Video in which Dr. McClellan perform a Full Thickness Skin Graft to the nose following Moh's cancer resection.
What is a Forehead Flap?
A forehead flap is a more invasive way to repair larger and more complex defects that are full thickness or may have lost cartilage or lining of the nose or face. The forhead flap involves bringing down tissue from the forehead based on an artery that is near your brow. The tissue is carefully dissected and the forehead skin and dermis is brought down onto the nose in order the rebuild the nose. This is a staged procedure and the patient will need to return to surgery in a few weeks in order to disconnect the bridge of forehead tisse and refine the appearance.
Click the picture watch a Video in which Dr. McClellan performs a forehead flap following Moh's cancer resection. Basal Cell Squamous Cell
Are these surgeries day surgery?
Yes most facial reconstruction cases are day surgery and are performed at the Mon Health Outpatient Surgery Center.
What is Eyelid Reconstruction?
Loss of eyelid tissue commonly occurs with the resection of cancer. on the eyelid. This can be upper eyelid or lower eyelid tissue. Reconstruction of the eyelid is complex due to the trilammenar construction of the lids. A mucosa layer, a strength layer of cartilage called the Tarsal plate, and the outer layer of skin / muscle make up the three layers. Understanding the anatomy of the orbit and the suspensory ligament systems of the eyelid is critical to successful reconstructions. Below is an example of a complex lateral eyelid defect and the repair.
