Mohs to Micro: Defining Reconstructive Tipping Points for Skin Reconstruction

Sunday, October 12, 2025

4:00 PM - 5:00 PM EDT

Location: 127

Disclosure(s):

Marianne Abouyared, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Antoine Eskander, MD Sc.M. FRCSC:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Brittny N. Tillman, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Scott A. Mclean, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

PROGRAM DESCRIPTION: This comprehensive session will explore the delicate balance of the art and science of reconstructing skin cancer defects in the head and neck. Through eye-opening case examples and expert demonstrations, attendees will become familiarized with skin substitutes, local flaps, and when a free flap is finally necessary. Attendees will see first-hand how even the largest defect may be closed with a local flap, and when the tipping point of needing free tissue may be reached.

Reconstructive challenges, as they pertain to skin cancer, will also be introduced through case-base discussion. Specifically, wound healing will be discussed, particularly as immunotherapy is now a mainstay in treating advanced melanoma and non-melanoma skin cancers. In advanced cancers, adjuvant radiation is also often recommended following reconstruction, and the panelists will describe how the future exposure to radiation may guide your reconstructive choice. This evidence-based discussion will allow attendees to better understand these nuances and potential wound-healing pitfalls if their patients are going to receive or have received these nonsurgical treatments.

Lastly, case-based discussions will help attendees understand the difficult conversations that may arise when a skin cancer is in a particularly morbid and difficult-to-reconstruct location of the head and neck. When to operate, and when NOT to operate, will importantly be considered, and on the other side of the spectrum, panelists will discuss when palliative surgery may be necessary. This comprehensive session will benefit any otolaryngologist who wishes to expand their practice to in caring for patients with skin cancer and in reconstructing skin cancer defects, ranging from those supporting a mohs surgeon to those who deal with more advanced tumors.

OUTCOME OBJECTIVE 1: Demonstrate reconstructive indications and limitations of grafts, local, regional, and free flap reconstruction of cutaneous defects.

OUTCOME OBJECTIVE 2: Discuss situations in which wound-healing may be compromised, including in those patients on immunotherapy and/or when adjuvant radiation may be required.

OUTCOME OBJECTIVE 3: Evaluate advanced skin cancer cases with difficult decision-making, and when non-operative measures versus palliative surgery should be considered.

BACKGROUND STATEMENT: This session will span the breadth of skin cancer reconstruction from mohs defects to larger wounds. As immunotherapy is more common, operating on these patients now comes with new challenges. Participants will leave feeling comfortable evaluating these advanced skin cancer patients.

Comprehensive Otolaryngology Track Statement :

Moderator(s)

Marianne Abouyared, MD

Associate Professor
University of California, Davis
Sacramento, California, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Panelist(s)

Marianne Abouyared, MD

Associate Professor
University of California, Davis
Sacramento, California, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Antoine Eskander, MD Sc.M. FRCSC

Associate Professor
University of Toronto
Toronto, ON, Canada

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Brittny N. Tillman, MD

Associate Professor, H&N Fellowship Director
UT Southwestern Department of Otolaryngology
Dallas, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Scott A. Mclean, MD, PhD

Associate Professor
University of Michigan
Ann Arbor, MI, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.