Dr. Carlos Cutini

Mohs Micrographic Surgery with an Oncoplastic Perspective

Non-melanoma skin cancer is the most common malignancy, and the surgical strategy determines long-term outcomes. This masterclass presents an approach that combines Mohs micrographic surgery (MMS) with oncoplastic skin surgery to maximise oncologic control, preserve healthy tissue, and optimise both function and aesthetics.  We review why MMS remains the gold standard—offering complete margin control, tissue preservation, and lower recurrence—contrasted with wide-margin resection, which provides safety at the frequent expense of function and cosmesis. Evidence and clinical experience are used to highlight when MMS confers clear advantages and how margin-directed excision can expand reconstructive options.  Building on these principles, the session outlines an oncoplastic philosophy centred on defect-oriented planning and tailored reconstruction—planning resection and reconstruction as a single continuum to deliver the best outcomes. Practical algorithms and case illustrations emphasise safeguarding uninvolved skin and ensuring that every feasible reconstructive alternative is considered.  The core idea is to follow oncoplastic principles in all skin cancer surgery; achieve precise oncologic resection; preserve healthy tissue; and select the reconstruction that best restores form and function.