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Reconstructive Surgery

Following the removal of your skin cancer we will discuss with you the options for repairing the surgical wound. The surgical wound will be repaired by stitching the edges together or by using a skin graft or skin flap. These repairs are usually, but not always, performed on the day of your surgery. Occasionally, we must delay the repair until the next day.


Dr. Clark and Dr. Flynn are extensively trained in surgical reconstruction. This includes basic closures, and more complicated skin flaps and skin grafts. They perform hundreds of these procedures each year. Our goal is to provide you the best possible cosmetic result after the removal of your skin cancer.

The size and depth of the surgical wound after removal of your skin cancer can not be predicted in advance. The method of reconstruction can not be predetermined either. After tumor removal is complete the options for reconstruction will be reviewed with you. In some instances, we may recommend you see a plastic or head & neck surgeon (ENT) for your repair.
At the completion of your surgery and repair, we will give you printed instructions on how to care for your wound.

Options for Management of Surgical Wounds:

  • Direct Closure: This is the most common method of repair. The wound edges are brought together to form a linear closure. Most surgical wounds following removal of the skin cancer are circular. When these wounds are closed by direct closure some puckering is produced at both ends. These puckers must be removed to produce a straight line, which is longer than the original diameter of the wound. Our goal is to hide this scar line in a pre-existing crease when possible.

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  • Skin Flaps: Some surgical wounds are best repaired using a flap. A skin flap is when nearby tissue is recruited to cover the surgical wound. Many types and designs of skin flaps are used in order to restore function and produce the best possible cosmetic result. Smoking has been shown to decrease skin flap survival. We recommend stopping all smoking for a period 2 weeks before and 2 weeks after your surgery.
  • Skin Grafts: When surgical wounds cannot be easily repaired by direct closure or a flap we will often use a skin graft. A skin graft is a procedure in which a piece of skin is removed from one part of the body and then transferred to another. Donor skin for skin grafts is usually taken from in front or behind the ear. The scar from the skin graft can usually be hidden around the ear in natural skin lines. Smoking has been shown to decrease skin graft survival. We recommend stopping all smoking for a period 2 weeks before and 2 weeks after your surgery.
  • Second Intention: This method allows the wound to heal on its own without any further surgery. A bandage is worn for 8-12 weeks while the area heals. As a rule, wounds left to heal by second intention do not produce as good a cosmetic result as sutured wounds. The patient must also wear a bandage for a prolonged period, which varies depending upon the size of the wound.