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Mohs micrographic surgery has become a gold standard in treating certain types of skin cancer, particularly those in sensitive areas or with a high risk of recurrence. While the primary goal of Mohs surgery is to completely remove cancerous cells, the procedure often leaves behind noticeable defects that usually require reconstruction. However, patients often wonder whether such reconstruction is necessary and if it’s covered by insurance. Let’s delve into these questions to shed light on what to expect.

Understanding Mohs Surgery and Reconstruction

Mohs surgery involves the meticulous removal of skin cancer layer by layer, with immediate microscopic examination to ensure complete excision while sparing healthy tissue. While this technique boasts high cure rates, it can leave behind wounds of varying sizes and depths, particularly on the face, where tissue preservation is crucial for cosmetic and functional reasons.

The need for reconstruction following Mohs surgery depends on several factors, including the size and location of the defect, the cosmetic concerns of the patient, and the potential functional impairment. Smaller defects may heal adequately on their own or with minimal intervention, while larger or more complex defects often benefit from surgical reconstruction to optimize cosmetic outcomes and restore functionality.

Reconstruction techniques following Mohs surgery vary based on the extent of the defect and the patient’s individual needs. Common methods include;

  • Primary closure
  • Skin grafts
  • Local flaps
  • Regional flaps

The choice of technique depends on factors such as the size and location of the defect, tissue laxity, and the patient’s overall health.

Insurance Coverage

One of the primary concerns for patients undergoing Mohs surgery is whether insurance will cover the cost of reconstruction. While coverage policies vary depending on the insurance provider and the specific terms of the policy, Mohs surgery and subsequent reconstruction are often considered medically necessary procedures when performed to treat skin cancer and restore function or cosmesis.

Most insurance plans, including Medicare and private insurers, typically cover the cost of Mohs surgery and medically necessary reconstruction. However, coverage may be subject to deductibles, co-pays, and prior authorization requirements. It’s essential for patients to consult their insurance provider and the treating physician to understand their coverage and any potential out-of-pocket expenses.

Navigating the Process

For patients facing Mohs surgery and potential reconstruction, open communication with both the dermatologic surgeon and the reconstructive surgeon is key. Understanding the treatment plan, including the need for reconstruction and associated costs, can help patients make informed decisions about their care.

Patients should also proactively engage with their insurance provider to verify coverage and understand any financial obligations. This may involve obtaining pre-authorization for surgery and reconstruction, as well as clarifying coverage for specific procedures and associated costs.

Throughout this process, guidance and expertise from specialists like Dr. Sam DeVictor at DeVictor Facial Plastic Surgery can be invaluable. Dr. DeVictor’s extensive experience in facial reconstruction ensures that patients receive personalized care and optimal outcomes tailored to their unique needs.


Mohs surgery is a highly effective treatment for skin cancer, offering high cure rates while preserving healthy tissue. While reconstruction may be necessary to optimize cosmetic outcomes and restore function, the decision to undergo reconstruction should be made in consultation with the treating physicians and based on individual patient needs and preferences.

Fortunately, insurance coverage for Mohs surgery and reconstruction is typically available, although specific coverage policies may vary. Patients should advocate for themselves by understanding their insurance coverage, communicating openly with their healthcare providers, and actively participating in the decision-making process to achieve the best possible outcomes. With support from experts like Dr. Sam DeVictor at DeVictor Facial Plastic Surgery, patients can navigate the process with confidence, knowing that reconstruction options are available and supported by insurance coverage in many cases.

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