Facial Reconstruction in Sarasota, FL

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Dr. Derby regularly performs facial reconstructive surgery following skin cancer excision. The ideal outcome for each patient is a restoration of form and function, and minimization of scar appearance following skin cancer treatment. Skin cancer surgery is focused on removing all cancerous cells while sparing as much healthy tissue as possible. This procedure, often performed by Dr. Derby’s colleagues that perform Mohs surgery, should be followed by a careful and cosmetic wound closure. In more advanced cases of skin cancer, the skin cancer removal surgery can result in a larger defect that can be located on crucial structures such as the lips, eyelids or nose. This subsequent cancer defect can result in significant disfigurement that should be repaired by a plastic surgeon well versed in facial reconstructive surgery. Skin cancer reconstruction can be performed immediately after your skin cancer is removed, or after you have healed from a prior procedure. The treatment plan is based on your individual needs, and Dr. Derby provides professional guidance during your consultation.

Surgical Technique

 There are several methods of reconstruction that can be used, depending on the size and shape of the affected area. Dr. Derby will work in coordination with your medical team to begin the reconstruction process as soon as possible. In the event of a very severe case, a large defect, or a patient’s other medical problems, reconstruction may need to be delayed. There are many methods that Dr. Derby uses when it comes to cancer defect reconstruction. For smaller defects, a very meticulous layered wound closure may be all that is needed for an aesthetically excellent result. For larger defects, tissue may need to be rotated or advanced into the defect in order to minimize deformity. More significant defects may require more distant flaps, cartilage or fat grafts, skin grafts, or a staged multiple procedure approach. Plastic surgeons are trained in molding, shaping, and rearranging delicate soft tissue. The plastic surgeon’s specialty, by definition, is to conceptualize the least conspicuous and best matching donor sites for this tissue trade, often aesthetically “borrowing from Peter to pay Paul.” 


The recovery process is mainly concerned with the care of the wound site during healing. This is to ensure that the fresh suture line is not subjected to mechanical stresses such as motion, force or swelling. Following Dr. Derby’s specific instructions can help reduce tension and wound disruption and ultimately help produce the best and finest surgical scars. After surgery, extensive instructions are provided concerning wound care, bathing, resuming normal activities, returning to work and when to follow up with Dr. Derby.

Extra Information

Dr. Derby uses a wide variety of flaps, skin grafts, and tissue expansion techniques for facial defect reconstruction. For the largest and most complicated defects, a method called microvascular free tissue transfer, or a “free flap,” may be required. In this procedure, skin, soft tissue and sometimes bone tissue is harvested along with supporting blood supply. The blood supply to this tissue includes a feeding artery and a draining vein. The tissue is harvested from a donor area that can be more easily and aesthetically closed. This free flap is then transplanted into the cancer defect and the artery and vein are connected to recipient vessels under the microscope with microsurgery. This procedure is quite complex, but may be necessary when large areas of tissue have been removed by the surgical oncologist. Some flap procedures require more than one surgery to ensure blood supply is established.

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Recovery Time  
1-2 Weeks
Average Procedure Time  
1 Hour
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The board-certified plastic surgeons of Sarasota Plastic Surgery Center, Dr. Braun Graham, Dr. David Mobley, Dr. Scott Engel, and Dr. Brian Derby, offer a comprehensive range of cosmetic plastic surgery procedures. All information subject to change. Images may contain models. Individual results may vary. Individual results are not guaranteed.