Eyelid and Facial Reconstruction

Skin Cancer Resection and Repair

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.

"I could tell you 'Thank you' a million times and it still would not be enough to repay you for what you did for us! We very much appreciate you for taking great care of our son."
— Beth —
"A quick note of thanks for all of your efforts on my behalf in regard to my eyebrow work. Your entire organization deserves an A+ from my experience."
— Walter —
"In a time of fear, chaos, and pain you have provided us with some much needed comfort and reassurance. We appreciate the opportunity to have become your patient."
— Kelly —
"I love the way I look after only 3 months and I have had amazed looks and interesting and positive comments from friends and family. Thank you so much for your wonderful care."
— Judy —
"Just wanted to let you know how much we appreciate all you've done for our family, especially our son. You are according to him, AWESOME!"
— Max's family —
"I've never had such a good time in surgery. I want to thank everyone who cared for me, but a very special thanks to Dr. Klapper."
— Linda —
"I just wanted to say thank you for my new eyes. I can't believe the difference that it has made. You were all so kind and I appreciate your patience. You are the best!"
— Vicki —
"You are so patient with all my many questions, and you deserve many plaudits for your warm and friendly 'bedside manner' and your ability to explain so well."
— Faye —

Dr. Klapper treats disorders, injuries, and other abnormalities of the eyelids, eyebrow, tear duct system, eye socket, and adjacent areas of the mid and upper face.

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