Skin cancer surgery: Double Advancement Flap on upper lip

This patient had Mohs Micrographic Skin Cancer Surgery to remove a basal cell carcinoma, a type of skin cancer on his upper lip. Although at this size, this type of skin cancer is not life threatening, however, it is locally destructive, so needs to be removed, and Mohs Surgery is the ideal technique that removes as little as skin as possible, leaving as small a possible secondary defect (wound), and therefore, likely the smallest scar possible.
Due to the location of the wound (area of skin removed after Mohs surgery), I opted to create a double advancement flap, a type of flap that advances tissue from two different directions, and hides the scar well within natural creases in the face (in this case, the junction between the nasal ala and the upper lip and cheek). This avoids creating pulling of the tissue in noticeable ways, such as avoiding pulling up of the corner of his right lip, or distorting the shape of the right side of his nose.
This is a procedure done in the office under local anesthesia, and is something I do at least a couple days a week. Thank you for watching!!

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Periscope: Dr. Sandra Lee

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