Mohs and Plastic Surgery for Squamous Cell Carcinoma in Situ on the Upper Nose*

Procedure Details

This 50 year old female was referred to our office with a lesion on her upper nose near the right medial canthus. A biopsy revealed squamous cell carcinoma in situ, keratotic type and Mohs surgery was recommended primarily due to the location of the skin cancer. Mohs surgery was performed followed by plastic surgery for reconstruction. The procedure performed for reconstruction was a complex repair (linear repair closed in layers). Patient had sutures removed six days later and then follow-up was six weeks after that. No other treatments were needed for this patient. The patient is very happy with her results.

What is a "complex repair"?

There are many way to stitch a wound closed.  Most wounds are stitched as a straight line, AKA linear repair.  However, there are different ways or techniques to pull the skin edges together.  We most often classify linear repairs into one of 3 categories: 

1. "Simple Repair" - A single layer of stitches are used to pull the layers of skin together.

2. "Intermediate Repair" - At least two layers of closure are performed to pull the skin together.  A small amount of "undermining" of the skin edges may also be performed.

3. "Complex Repair" - At least two layers of closure are performed to pull the skin together.  More significant  "undermining" of the skin edges is performed.

What is "undermining"?  Skin is attached to the underlying layers by small fibers.  Undermining releases these fibers and allows the skin to slide together more easily.  Typically a small surgical blade or surgical scissors are used to release these fibers


Skin Cancer Consultants

*All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.