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Mohs Facial Reconstruction

Mohs facial reconstruction is a specialized surgical technique to address facial defects that arise as a result of Mohs micrographic surgery, a precise method for treating skin cancer, particularly those located in sensitive and cosmetically important areas of the face. Mohs micrographic surgery involves methodically removing skin cancer tissue layer by layer while preserving healthy surrounding tissue. This approach minimizes scarring and ensures the complete removal of cancer cells, making it a preferred method for treating facial skin cancer.

Once the cancerous tissue is removed, you may be left with a wound or defect on the face. At this point, Dr. Guida works to restore the function and aesthetics of the affected area. Using advanced techniques, he carefully closes the wound, utilizing nearby healthy tissue, grafts, or flaps to reconstruct the facial features. Mohs facial reconstruction plays a crucial role in helping patients regain their confidence and appearance following skin cancer treatment while preserving the integrity of their facial structures.

Techniques Used for Mohs Facial Reconstruction:

  • Flap Surgery: During flap surgery, Dr. Guida creates a flap of healthy tissue adjacent to the defect and repositions it over the wound site. This method allows for the transplantation of tissue with its blood supply, promoting better healing and reducing the risk of complications. Flaps can be local, regional, or distant, depending on the size and location of the defect.
  • Skin Grafts: Skin grafts involve the transplantation of skin from one area of the body (donor site) to the facial defect. This is particularly useful for larger defects where there may not be enough nearby healthy tissue for flap surgery. Skin grafts come in two primary types: split-thickness grafts, which include only a portion of the skin’s layers, and full-thickness grafts, which involve the entire thickness of the skin.
  • Local Tissue Rearrangement: Local tissue rearrangement techniques involve repositioning adjacent healthy tissue to cover the facial defect. This method can minimize the need for extensive grafts or flaps and is especially beneficial for smaller defects. Dr. Guida uses his expertise to reshape and reorient the surrounding tissue to conceal the wound.

Facial Lesion Removal

Facial lesion removal is a medical procedure to eliminate various abnormal growths or skin imperfections on the face. These lesions can range from benign moles, cysts, and skin tags to potentially cancerous growths like basal cell carcinoma, squamous cell carcinoma, or melanoma. The primary goals of facial lesion removal are to ensure safety, improve cosmetic appearance, and, in the case of malignant lesions, prevent the spread of cancer.

The procedure begins with a thorough evaluation to assess the nature and extent of the facial lesion. Depending on the diagnosis, various removal techniques may be used, such as excision, laser therapy, cryotherapy, or electrosurgery. These methods are selected based on the lesion’s size, location, and characteristics. After removal, the tissue is sent for laboratory analysis to confirm whether it is cancerous or benign.

Techniques Used for Facial Lesion Removal

  • Excision: Excision involves surgically cutting out the facial lesion using a scalpel. This is commonly used to remove larger or suspicious lesions, as it allows for a precise and complete removal of the affected tissue. After excision, the wound is typically closed with sutures, and the excised tissue may be sent for examination.
  • Laser Therapy: Laser therapy uses focused, intense light energy to target and vaporize the lesion. It is particularly effective for smaller and superficial lesions like certain types of birthmarks, warts, or benign vascular growths. Laser removal is relatively bloodless, and it offers the advantage of minimal scarring and a shorter recovery period.
  • Cryotherapy: Cryotherapy involves freezing the facial lesion using liquid nitrogen or another cryogenic agent. The extreme cold causes the lesion to blister and eventually slough off. This technique is commonly used to remove warts, actinic keratosis, and some small benign skin growths. Cryotherapy is a quick procedure that requires little to no anesthesia.
  • Electrosurgery: Electrosurgery utilizes electrical currents to cut, coagulate, or vaporize the facial lesion. An electrically charged wire or needle-like electrode is applied to the lesion to remove or destroy it. Electrosurgery can be used for various lesion types and sizes. It provides excellent control over bleeding and causes minimal scarring.

Nasal Fracture Repair

Nasal fracture repair is performed to restore the normal alignment and function of the nasal bones when they have been broken or displaced due to trauma, injury, or accident. The nose is a prominent facial feature, and nasal fractures can result in cosmetic deformities and functional issues, such as difficulty breathing. Nasal fractures are a relatively common type of facial injury, often occurring as a result of sports injuries, automobile accidents, falls, or altercations.

The procedure typically begins with a thorough evaluation of the extent of the nasal injury, which may include X-rays or CT scans to assess the fracture’s severity and exact location. Dr. Guida carefully manipulates the nasal bones into their proper position to correct deviations or deformities. In cases where the nasal septum (the cartilage dividing the nostrils) is affected, septoplasty may be performed to address breathing difficulties. After realignment, Dr. Guida may use nasal packing or splints to support the newly repaired nasal structure during healing.

Facial Bone Fracture Repair

Facial bone fracture repair is a surgical procedure to restore the normal alignment, function, and aesthetics of the facial bones when fractured or displaced due to trauma, accidents, falls, or other injuries. The face is a complex structure consisting of various bones, including the mandible (jawbone), maxilla (upper jaw), nasal bones, orbit (eye socket), and more. These bones are critical in essential functions like eating, speaking, and breathing. Facial fractures can result in disfigurement, pain, and functional impairments.

The procedure begins with a thorough assessment, often including imaging studies like CT scans, to determine the extent and location of the facial fractures. Depending on the specific fracture pattern, location, and severity, facial bone fracture repair may involve open reduction (with incisions) or closed reduction (manual manipulation without incisions). Surgical fixation methods like plates, screws, or wires may be used to stabilize the fractured bones. Dr. Guida meticulously realigns the bones to restore facial symmetry, function, and aesthetics.

Experience Artistic
Surgical Judgment

Dr. Robert Guida is a highly skilled and experienced facial plastic and reconstructive surgeon in Manhattan. He is double board-certified by the American Board of Facial Plastic & Reconstructive Surgery and the American Board of Otolaryngology. He has performed facial plastic and reconstructive surgeries for over 30 years and has a sterling reputation, as evidenced by his multi-generational clients who trust him to deliver safe, consistent results. Please schedule a consultation with Dr. Guida to restore facial appearance and functionality.

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