Introduction
Skin cancer occurs when abnormal cells overgrow in the skin, resulting from damaged DNA that mutates. These mutations cause skin cells to multiply, resulting in malignant tumors that grow quickly. The main causes of skin cancer include cumulative exposure to UV rays from sun exposure without proper protection or excessive tanning. There are three main types of skin cancer, including basal cell carcinoma (BCCa), squamous cell carcinoma (SCCa), and melanoma.
As a facial plastic surgeon in San Francisco, Dr. Block-Wheeler does not diagnose skin cancer; he defers that to his dermatology colleagues. He assists with reconstructive surgery when needed after dermatologic treatment, particularly after Mohs surgery.
Skin cancer reconstruction surgery restores both the function and natural appearance of the skin following the removal of cancerous tissue. Once a dermatologist has excised the cancer — often through Mohs surgery — Dr. Block-Wheeler steps in to reconstruct the affected area, focusing on minimizing scarring and preserving the unique, complex features of the face.
Mohs surgery is a highly precise, outpatient procedure performed under local anesthesia by a dermatologist who specializes in this technique. It offers the highest cure rate available (up to 99% for previously untreated skin cancers), making it a gold standard in many cases.
The procedure is completed in stages during a single visit. The Mohs surgeon removes a thin layer of tissue from the affected area and examines it under a microscope while you wait. If cancer cells are still present at the margins, the process is repeated layer by layer until the tissue is completely clear. This meticulous method ensures complete cancer removal while preserving as much healthy tissue as possible, resulting in the smallest defect necessary.
Because of its tissue-sparing benefits, Mohs surgery is especially favored for cosmetically and functionally sensitive areas like the nose, lips, ears, and eyelids, where preserving normal appearance and function is critical.
In some cases, the wound may be small enough to heal on its own, but when a more noticeable defect remains, Dr. Block-Wheeler will perform reconstructive surgery, typically within a few days of your Mohs procedure. Our team works closely with your Mohs dermatologist to coordinate care, minimizing the time between cancer removal and reconstruction. For more extensive or deeper defects, multiple reconstructive procedures may be required to achieve optimal functional and aesthetic results.
Curettage and electrodesiccation is a common skin cancer removal technique typically used for small, superficial basal cell or squamous cell carcinomas that are not located in cosmetically sensitive areas. In this procedure, your dermatologist will use a sharp instrument called a curette to scrape away the cancerous tissue gently. Afterward, the area is treated with an electric needle (electrodesiccation) to destroy any remaining cancer cells and to stop bleeding. This process may be repeated several times during the same session to ensure thorough treatment.
Although this method is quick and effective for certain types of skin cancer, it can leave a round, shallow wound that may heal with some textural or color changes. If the defect is in a visible area or does not heal optimally, Dr. Block-Wheeler may be consulted to perform a secondary procedure to improve the appearance of the site or to assist in initial closure if needed, particularly if function or aesthetic contour is a concern.
Excisional surgery involves surgically removing the skin cancer along with a margin of surrounding healthy tissue to ensure all malignant cells are eliminated. This method is often used for larger or more deeply rooted tumors and is sometimes recommended when Mohs surgery is not an option or necessary.
After the dermatologist or surgical oncologist completes the excision, the resulting defect may vary in size and depth depending on the tumor’s location and extent. Dr. Block-Wheeler is often consulted for reconstruction, particularly when the removal is located in a highly visible or delicate area such as the face. He will use advanced surgical techniques, including skin flaps or grafts when necessary, to close the wound in a way that maintains both natural appearance and proper function. His goal is to help patients heal in a way that feels seamless, with minimal visible scarring.
Individuals who have been diagnosed with skin cancer, have recurring skin cancer, have skin cancer that is growing rapidly, or have skin cancer in sensitive areas such as the eyes, nose, or lips need to see their dermatologist for proper cancer treatment. Dr. Block-Wheeler will speak with you during your consultation appointment in San Francisco to discuss your surgical reconstructive options regarding the anticipated skin cancer defect you may have after your removal. He understands that it can be nerve-wracking for you when diagnosed with skin cancer, but he will do everything to ensure that you are fully informed on your reconstructive options and make recommendations on what your surgery may entail.
Patients benefit from the preservation of facial balance and natural expression, reduced visible scarring, and the restoration of sensitive areas such as the nose, lips, and eyelids to ensure proper function.
The procedure also supports complete healing after cancer treatment and helps achieve results that look as natural as possible while protecting long-term skin health.
The first step is to meet with Dr. Block-Wheeler for a private consultation in San Francisco. If you have recently been diagnosed with skin cancer and your dermatologist has scheduled or completed your removal procedure, you can request that Dr. Block-Wheeler be part of your care team for the reconstruction phase.
During your consultation, Dr. Block-Wheeler will review your dermatology records, examine the anticipated or existing defect, and discuss your reconstruction options in detail. He will also explain the recovery timeline, possible outcomes, and the techniques that may be best suited for your unique case.
There are many different ways to remove skin cancers, depending on the type, size, and location of the growth. The most common skin cancer techniques include Mohs surgery, curettage and electrodesiccation, and excisional surgery.
In most cases of skin cancer reconstruction surgery, patients will experience swelling, bruising, and tenderness in their first week of recovery. Their stitches will be removed within five to seven days after surgery, although full healing of the incision line can take several weeks.
Most of our San Francisco and Marin patients return to their daily activities within a week, though anything too strenuous should be avoided until cleared. Over the following months, scars continue to mature and fade, with results becoming increasingly natural as time passes.
The cost of skin cancer reconstruction in San Francisco will depend on the size of the area you’re looking to have treated, the complexity of the repair, and the number of procedures required.
For example, a small repair on the cheek may be relatively straightforward, while reconstruction on the nose, lips, or eyelids can be more complex and may require multiple stages. Because every case is different, Dr. Block-Wheeler provides a detailed cost estimate after your consultation once he has assessed your specific needs.
In many cases, reconstruction following skin cancer removal is at least partially covered by insurance. Our office staff is happy to help you navigate your benefits and coordinate with your dermatologist or Mohs surgeon so you know what to expect financially before moving forward.
Our Ethos
When it comes to facial reconstruction after skin cancer, results matter. This is not just about closing a wound; it is about restoring both appearance and function in a way that looks and feels natural. Dr. Block-Wheeler is a facial plastic surgeon who specializes in complex repairs of the nose, lips, and eyelids, drawing on his training in Otolaryngology (ENT), Head & Neck Surgery, and Facial Plastic Surgery.
His San Francisco and Marin patients choose him because he takes the time to listen, explain, and collaborate. He works directly with your skin cancer specialist to ensure that your reconstruction is handled thoughtfully and with expert care, always with the goal of helping you feel confident in your results.
If you need skin cancer reconstructive surgery, contact our San Francisco, CA, office today and let your dermatologist and Mohs surgeon know you are interested in having the defect reconstructed by a facial plastic surgery specialist. We will schedule your initial consultation appointment with facial plastic surgeon Dr. Block-Wheeler. During this appointment, Dr. Block-Wheeler will discuss your skin cancer reconstructive options depending on the anticipated defect, which is at times not completely predictable. The focus is always first and foremost to have the cancer removed completely, with reconstruction of the defect being a secondary goal. If you smoke or consume nicotine, this may be a good time to stop.