PROCEDURES


PROCEDURES


Client Testimonial

My Mohs surgeon referred me to Dr Khosh to discuss repair after removing skin cancer from my nose. Dr. Khosh instantly made me feel at ease. He explained all of the treatment options with patience. He is knowledgeable, personable, caring and, most importantly, very skilled. I highly recommend him to anyone considering skin cancer reconstruction.

Person

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The most common cause for development of skin cancer is damage from sun exposure. Frequent types of skin cancer are: Basal Cell Carcinoma, Squamous Cell Carcinoma, and Melanoma. Mohs' micrographic surgery is the accepted technique for removal of basal cell and squamous cell skin cancers on the face. The Mohs' technique minimizes the extent of tissue removal and the risk of cancer recurrence. Dr Khosh works closely with Moh's dermatologist-surgeons to repair facial defects following cancer removal.

Various techniques like skin grafts, skin flaps, or skin and muscle flaps can be used in repair of facial defects. Dr. Khosh prefers to see patients in consultation for skin cancer reconstruction prior to the excision. In this way, the reconstructive options can be more fully discussed, and the excision and repair procedures can be better coordinated. In most cases, the repair can be performed under local anesthesia in our offices. Occasionally, skin cancer reconstruction needs to be done in the operating room, where sedation or general anesthesia can be offered.

We understand that surgery on the face can be quite a daunting from a patient's perspective. We strive to make the process less foreboding by allying your concerns in regards to the aesthetic effects of the surgery on your face. Dr. Khosh is an expert in reconstruction of cancer defects on the face. He has published and lectured extensively on this subject. Many patients travel from under regions of the country for consultation and secondary reconstruction of old skin cancer defects. You may review some of Dr. Khosh's publications on line at www.emedicine.com. (Lip reconstruction, Upper eyelid reconstruction, Full thickness skin graft)

Skin cancer reconstruction can be categorized according to the various facial areas. In our website you can learn more about skin cancer reconstruction of the scalp, the forehead, the eyelids, the nose, the cheeks, the lips, the chin, the ears, and the neck. Secondary procedures such as laser treatments, scar revisions, and steroid injections can help improve the reconstructive results. Please contact our office to schedule a private consultation to discuss primary or secondary repair of a skin cancer on the face.

  • 2010 Patients' Choice Award
  • 2008-2009 & 2010-2011 Best Doctor List.
  • Past President of New York Facial Plastic Surgery Society.
  • Assistant Clinical Professor at Columbia University.
  • Past Director of Facial Plastic Surgery at Columbia Univeristy.
  • Founding Member of new York Head & Neck Institute.
  • Affiliate Member of Vascular Birthmarks Institute of New York.
  • 2001 Columbia University Maxwell Abramson Teaching Award.

Case Study

This 76 year old lady requested consultation for nasal repair in Manhattan. She had removal of a Basal Cell Cancer from her nose which resulted in the loss of the majority of her nostril rim. A two stages naso-labial flap was used to restore her nostril.

  • Patient: 76 year old female candidate for nose repair after cancer removal
  • Problem: 0.5 x 0.75 inch defect of the nostril rim
  • Procedure: Naso-labial flap repair of the nose

FAQS

What kind of anesthesia is used in skin cancer reconstruction?
Small skin cancer defects are easily repaired under local anesthesia during an office procedure. Larger skin defects on the face, which require complicated flaps, require sedation or general anesthesia.
What is the difference between a partial thickness skin graft and a full thickness graft?
A full thickness skin graft implies the harvest of all layers of skin. During a partial thickness graft harvest, skin in only removed at the depth of papillary dermis while leaving the deeper dermis intact. Partial thickness skin graft harvest sites can regenerate the skin that was removed. Full thickness harvest sites need to be reconstructed, as the skin cannot regenerate. Full thickness skin grafts usually provide a better aesthetic result.
What is the difference between a skin graft and a skin flap for skin cancer reconstruction?
Skin grafts are pieces of skin that have been completely detached and require in growth of new blood supply to survive. Skin flaps are prices of skin that remain attached to a source of blood supply while transferred to a new site. In general, skin flaps provide a superior aesthetic result in skin reconstruction.
What is a forehead flap repair of a nose defect?
Forehead flaps are quite useful in repair of large skin cancer defects on the nose. A vertically oriented flap of skin, extending from the central brow to the hairline, is rotated down to cover the nasal defect. The blood supply at the base of the flap, at the level of the eyebrow, is left intact for two weeks. In a secondary procedure, the base of the flap is cut and the flap is completely inset.
What is a nasolabial flap for repair of nose defect?
Nasal defects that involve the nostril rim can be repaired with a skin flap that is harvested from the fold of skin extending form the nose to the corner of the lip. The skin and its intact blood supply are rotated to the site of defect. In certain cases, a secondary procedure is necessary for final inset of the flap.

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