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Mohs Micrographic Surgery - Basal Cell Carcinoma On The Temple

A 61 year-old male patient, presented to our office for the evaluation of an infiltrative basal cell carcinoma of the left temple.  This lesion had been surgically removed by his previous physician twice prior with recurrence following each excision.    He consulted our office to discuss treatment utilizing the Mohs surgical technique.  After reviewing the treatment options, the patient decided that Mohs surgery would be the best method to clear the tumor once and for all.  A significant defect remained after 3 stages of Mohs micrographic surgery (Figure 1).

Figure 1.


The final defect could not be closed primarily.  Closure options including full thickness skin graft, and local tissue flaps were discussed.  Together with the patient, we agreed on an inferiorly based rotation flap to close the wound and hopefully keep the normal facial anatomy correct, particularly the level of the eyebrow.  The final closure can be seen below (Figure 2).

Figure 2.



Sutures were removed after one week (Figure 3) and at 4 weeks, the patient demonstrated complete healing, with minimal scarring an no effect on the position of the eyebrow (Figure 4).

Figure 3.


Figure 4.


Mohs surgery is the most ideal treatment for non-melanoma skin cancers. When performed by the right professional this is often the treatment with the highest cure rate, with the lowest rate of recurrence. It is a very slow process, but that is because each cute is then examined under a microscope to pin point where the skin cancer cells are. Providing you with the smallest cut, saving the greatest amount of healthy skin possible. You can read more about this surgery process in one of my previous blogs here: Mohs Micrographic Surgery Process

Dr. David Roy Lead Pine Belt Dermatology Physician

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