Surgical excision is the gold standard for management of most eyelid and facial skin cancers. A majority of skin cancers in the eyelid area are either basal cell carcinoma or squamous cell carcinoma. Other cancer types (such as sebacous cell carcinoma, malignant melanoma, and Merkel cell carcinoma) occur more infrequently and generally require wider excision, more specialized resection and reconstruction techniques, and a comprehensive oncologic (cancer) evaluation.
There are two basic approaches to basal cell and squamous cell carcinoma excision. Skin cancer removal can be performed at the time of reconstruction and the tumor margins examined (“frozen sections”) by a pathologist to ensure complete removal. Alternatively, microscopic-assisted resection may be performed by a dermatologic surgeon (“Mohs’ surgery”). This technique offers the potential advantages of less tissue removal and slightly greater confidence of complete cancer resection.
Following Mohs’ skin cancer resection, reconstruction is typically performed within 1 to 2 days but may be delayed up to a week after the Mohs' procedure. The complexity of reconstruction will, of course, depend on the size and location of the defect and if there is tear duct involvement. The main goal of repair is to restore adequate eyelid, brow, or facial function. Every attempt is also made to maximize the resulting cosmetic performance. Occasionally, secondary surgical procedures are necessary to modify excessive scarring, improve the position of the eyelid(s), correct tear duct abnormalities, or resect recurrent cancer.
**Recurrent disease can occur with any type of resection, so patients should have periodic examinations with their dermatologist, primary care physician, or Dr. Klapper following their surgery.**
Dr. Klapper has extensive experience in eyelid and upper and mid-facial skin and soft tissue reconstruction. Dr. Klapper works closely with several Mohs's surgeons throughout Indiana.
To see some of Dr. Klapper's patients, please visit the photo gallery. The images are divided into a few categories to simplify your search. Eyelid margin defects involve the margin or edge of the eyelid (the eyelash and tear duct location) and require different surgical techniques than non-marginal wounds.
The results shown are for educational purposes only and do not represent a guarantee of surgical results or postoperative appearance. All patients respond differently to surgical reconstruction.