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Scientific Oral Presentations

Facial Plastic and Reconstructive Surgery

Session: Scientific Oral Presentation 2 - Facial Plastics and Reconstructive Surgery

The Influence of Area Deprivation Index on Surgical Outcomes in Mohs Reconstructive Surgery

Monday, October 13, 2025

10:12 AM - 10:18 AM EDT

Location: 137

Introduction: Reconstruction is commonly performed for the restoration of facial defects following Mohs skin cancer excision. The aim of this study was to examine whether socioeconomic status, quantified by area deprivation index (ADI), is associated with differences in functional and cosmetic complications following Mohs reconstructive surgery.

Methods: A retrospective review of patients who underwent Mohs reconstructive surgery between 2021 and 2024 at a single tertiary-care institution was conducted. ADIs were calculated using patient zip codes and stratified into three groups, with the highest being the most marginalized: Group 1 (ADI 1-25), Group 2 (ADI 26-75), and Group 3 (ADI 76-100). Functional and cosmetic complications, as well as patient demographics were compared between groups.

Results: Among 93 patients analyzed, 53 patients were in Group 1, 37 patients in Group 2, and 2 patients in Group 3. There were no significant differences in age, comorbidities, insurance status, defect size, or revision rates between groups (p>0.05). Additionally, there was no significant difference in the incidence of functional complications (hematoma, dehiscence, infection, necrosis) between groups (p=0.571). However, the overall incidence of cosmetic complications (persistent erythema, scarring, pin cushioning, contour deformities) were significantly higher in Group 1 compared to the other groups (p=0.036), with contour deformities contributing most prominently (p=0.025).

Conclusions: While functional complication rates remain consistent across socioeconomic groups, differences in cosmetic complications may reflect variations in how ADI groups experience and report outcomes. Patients from lower ADI areas may have greater aesthetic demands, which could influence complication reporting. This underscores the importance of expectation management in postoperative counseling. Further studies should explore patient-reported outcomes and satisfaction metrics to better understand these existing disparities and optimize individualized postoperative care strategies.

Presenting Author(s)

Anne V. Seyferth, BS

Medical Student
Thomas Jefferson University
Philadelphia, PA, United States

Disclosure information not submitted.

Co-Author(s)

EF

Eric Fei, BA

Medical Student
Sidney Kimmel Medical College, Thomas Jefferson University
Philadelphia, PA, United States

Disclosure information not submitted.

Co-Author(s)

NG

Neha Garg, BA

Thomas Jefferson University, United States

Disclosure information not submitted.
VX

Vivian Xu, MD

Resident Physician
Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital
Philadelphia, PA, United States

Disclosure information not submitted.
PK

Praneet Kaki, BS

Thomas Jefferson University, United States

Disclosure information not submitted.
AA

Aarti M. Agarwal, MD

Resident Physician
Department of Otolaryngology - Head & Neck Surgery, UCSF
Philadelphia, PA, United States

Disclosure information not submitted.
KA

Khashayar Arianpour, MD

Cleveland Clinic Foundation, United States

Disclosure information not submitted.
HK

Howard D. Krein, MD, PhD

Professor
Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital
Philadelphia, PA, United States

Disclosure information not submitted.

Senior Author(s)

Ryan N. Heffelfinger, MD

Professor, Department of OTO-HNS
Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital
Philadelphia, PA, United States

Disclosure information not submitted.