Skin cancer on the eyelid, inner canthus, or nose requires two distinct specialists: a Mohs surgeon to remove the tumor with the highest cure rate, and an oculoplastic surgeon to reconstruct the delicate periocular anatomy without compromising vision or eyelid function. Belaray Dermatology in Hicksville, Long Island is the only practice in the Tri-State Area (NY/NJ/CT) where both procedures are performed under one roof — often on the same day. Dr. Rachel Ellis has provided oculofacial reconstruction alongside the practice's Mohs surgeons for two decades.
Why Location Matters for Skin Cancer Near the Eye
Basal cell carcinoma (BCC) accounts for approximately 85–95% of malignant eyelid tumors. The lower eyelid and inner canthus — the corner of the eye nearest the nose — are the most commonly affected sites. These locations are particularly challenging for two reasons:
Why standard excision falls short
- Standard excision samples only 1–2% of the surgical margin
- Positive margins on the eyelid may not be discovered for days
- Re-excision risks progressive tissue loss near critical structures
- Incomplete removal near the canthus has higher recurrence rates
Why Mohs surgery is preferred
- 100% of the peripheral and deep margin is examined in real time
- Removal stops exactly where cancer ends — maximum tissue preservation
- Up to 99% cure rate for primary BCC
- Same-day margin clearance — no waiting for pathology results
What Is Oculoplastic Surgery?
An oculoplastic surgeon (formally, an oculofacial plastic and reconstructive surgeon) is a subspecialist trained in both ophthalmology and plastic/reconstructive surgery. This dual training is specifically relevant for periocular reconstruction because the eyelid serves critical protective and functional roles:
- Corneal protection — incomplete eyelid closure (lagophthalmos) exposes the cornea to drying and injury
- Tear drainage — the canaliculi (small drainage ducts) in the inner canthus must be preserved or reconstructed to prevent chronic tearing (epiphora)
- Eyelid margin position — reconstruction errors can cause the eyelid to turn inward (entropion) or outward (ectropion), both of which cause pain, corneal damage, and cosmetic deformity
- Cosmetic symmetry — the periocular region is one of the most visually prominent areas of the face; symmetry, natural crease position, and contour require refined reconstructive technique
A general plastic surgeon or dermatologist performing closure in this region without oculoplastic training may technically close the wound — but the functional and aesthetic outcome may be compromised. Oculofacial plastic surgeons have dedicated fellowship training specifically in the functional and cosmetic anatomy of the periocular region.
How Same-Visit Reconstruction Works at Belaray
At most practices, a patient with periocular BCC faces a multi-step process: see a dermatologist for diagnosis, schedule Mohs surgery with a separate surgical practice, wait for pathology clearance, then schedule a separate oculoplastic reconstruction appointment — often at a different facility, sometimes weeks later. Patients may leave the Mohs facility with an open wound covered by a dressing, waiting for the reconstruction appointment.
The Belaray Difference
At Belaray Dermatology, dual board-certified Mohs surgeons and Dr. Rachel Ellis — board-certified by the American Board of Ophthalmology — work in the same facility at both offices. Once the Mohs surgeon confirms clear margins, Dr. Ellis performs reconstruction during the same appointment in the majority of periocular cases. Patients leave that day with the wound repaired rather than dressed and waiting.
This coordination benefits patients in several concrete ways:
- One appointment instead of two — tumor removal and reconstruction in a single visit
- No open-wound waiting period — reconstruction follows margin clearance the same day
- Shared surgical context — the reconstructing surgeon has direct knowledge of the defect, tissue quality, and available margins from the same procedure
- Single insurance workflow — one facility, one billing team
- Reduced patient burden — one trip for patients traveling from Nassau County, Suffolk County, or elsewhere on Long Island
For patients who feel anxious about surgery near the eye, Belaray offers Pro-Nox™ — a patient-controlled nitrous oxide system you breathe on demand during the procedure. Its effects wear off within minutes, so most patients can drive themselves home afterward.
Who Is a Candidate for Periocular Mohs Surgery with Same-Day Reconstruction?
Patients with any of the following may benefit from evaluation at Belaray:
- Diagnosed or suspected basal cell carcinoma or squamous cell carcinoma on the eyelid, inner canthus, outer canthus, eyebrow, nasal sidewall, or nasal tip
- Previously treated periocular skin cancer that has recurred
- Referred by a general dermatologist, ophthalmologist, or primary care physician for complex facial skin cancer near the eye
- Patients who prefer to minimize the number of surgical events and appointments
Referring physicians: Belaray Dermatology accepts referrals for periocular Mohs cases requiring same-day oculoplastic reconstruction. The Hicksville office is set up to handle complex defects with direct surgeon-to-surgeon coordination. Call (516) 822-7546 for referral scheduling.
Frequently Asked Questions
Why does eyelid skin cancer require an oculoplastic surgeon?
The eyelid is among the most anatomically complex regions on the face. Closure of even a small defect near the eyelid margin or canthus can disrupt the lacrimal drainage system, alter eyelid position (causing ectropion or entropion), or impair corneal protection. An oculoplastic surgeon — a subspecialist trained in both ophthalmology and plastic surgery — has the anatomical expertise to reconstruct these structures without compromising vision or eye function.
Can Mohs surgery and eyelid reconstruction happen on the same day?
Yes — at Belaray Dermatology. In the majority of periocular cases at Belaray's Hicksville office, Dr. Rachel Ellis performs reconstruction on the same day as Mohs tumor removal. Patients avoid a separate surgical scheduling process, additional anesthesia, and the logistical burden of coordinating between two practices and two surgical suites.
What is the most common skin cancer on the eyelid?
Basal cell carcinoma (BCC) accounts for approximately 85–95% of malignant eyelid tumors. The lower eyelid and inner canthus are the most commonly affected sites. BCC on the eyelid is often subtle — presenting as a painless pearly nodule or an area of lash loss — and is frequently diagnosed later than BCC elsewhere on the face.
Is Belaray the only Long Island practice with both Mohs and oculoplastics?
Belaray Dermatology is the only dermatology practice in the Tri-State Area (New York, New Jersey, Connecticut) offering both Mohs micrographic surgery and oculoplastic facial reconstructive surgery under one roof. This combination is unique to Belaray in the region.
Comparative “only” statements reflect a competitive-practice review based on publicly available practice websites and physician directories, reviewed August 2026.
Eyelid or Periocular Skin Cancer?
Schedule a consultation at Belaray Dermatology's Hicksville office. Our Mohs surgeons and Dr. Rachel Ellis coordinate same-day reconstruction for periocular cases. Most insurance plans accepted.