Primary excision is the procedure during which the entire tumor is removed with adequate surrounding tissue to ensure the complete removal of the tumor. This procedure is combined with some type of pathological evaluation of the specimen at the time of the surgery to ensure the complete removal of the tumor. This enables complete removal of the tumor without the need for repeat surgery. However, this does take longer because of the need for pathological evaluation.
Mohs Micrographic surgery is a type of primary excision that is performed by a trained surgeon. The tumor is removed and divided into quadrants (sections). The Mohs surgeon then evaluates the pathological specimen of each quadrant to determine if any tumor has been left behind in that specific area, and exactly where to take more specimens. The benefit of this procedure is not only the ability to determine if the entire tumor has been removed, but also to limit the amount of extra (normal) tissue that is removed and thus decrease the necessary size of the defect to reconstruct. This results in a smaller defect that is simpler to reconstruct.
Depending on the size of the defect, the location and comfort of the surgeon, various techniques can be used to reconstruct the primary defect by the reconstructive surgeon. Here at Osborne Head & Neck Institute, our fellowship trained reconstructive surgeons are fully capable of utilizing all of the available surgical techniques and technologies to achieve the best possible results. We offer facial reconstruction that utilizes the principle of facial harmony. It allows us to take into consideration the face as an entirety and not just the defect alone, and thus obtain a more harmonious reconstruction.
Aesthetic and Harmonious Reconstruction
At the Osborne Head and Neck Institute, we believe that the reconstruction of a facial defect should preserve the natural harmony of facial contours. Our surgeons are board-certified and fellowship-trained Facial Plastic and Reconstructive surgeons who have extensive training in surgery of the head and neck. They view the global picture of the face to design the best reconstructive approach for you. At times, due to the location or the extent of the defect, this cannot be achieved by simply repairing the defect. Additional procedures may be needed to bring symmetry and harmony to the face.
Functional Reconstruction (Why a Specialist?)
Certain locations on the face pose challenges in reconstruction. Locations such as the lip, nose and eyelids have vital functions and as such, careful attention needs to be paid during their reconstruction. Our Facial Plastic and Reconstructive Surgeons focus solely on the reconstruction of the face. Their training incorporates years of Head and Neck Surgery and Cosmetic and Reconstructive Surgery of the Head and Neck, where all cosmetic and functional aspects of the facial structures are studied. This makes the surgeons at the Osborne Head and Neck Institute the ideal surgeons for reconstruction of these regions.
For centuries, full lips have been a sign of youth and beauty. But the lips have vital functions as well, which need to be maintained during their reconstruction. Damage to the function of the lips can lead to significant problems, including alteration of eating, drinking and speech. During reconstruction, the muscular function of the lip must be re-established and the volume must be maintained to achieve a functional, and aesthetic result. There are also other reconstructive and cosmetic options available to improve the appearance of the lips if you have already had surgery. With a background in Facial Plastic and Reconstructive Surgery, our surgeons would be more than happy to answer any questions or concerns you have.
Due to the projection of the nose from the face, defects and abnormalities of the nose become increasingly more noticeable than other parts of the face. More importantly, the nose plays a vital role in breathing. It is far too common for a procedure to be performed to reconstruct the nose with good-looking results that sacrifice function, leaving patients unable to breathe through their nose. At Osborne Head and Neck Institute, we pride ourselves on our ability to comprehensively treat the nose internally and externally. This experience allows us to approach defects of the nose with a complete understanding of its function and anatomy, achieving excellent results.
In order to achieve optimal results both functionally and cosmetically, you may require adjunct procedures such as septoplasty, turbinectomy or rhinoplasty. For further details you may click here.
Skin cancer can affect the eyelid, and the defect that remains can be devastating. The eyelids function to open and close the eyes, as well as protect and moisturize the eyes. Retaining function during reconstruction of the eyelid is therefore of critical importance.