Skin Cancer Surgery
Hearing a diagnosis of “cancer” is very difficult to accept. Understanding that treating your skin cancer may result in scars or disfigurement can also be troubling. Your plastic surgeon understands your concerns and will guide you through treatment and explain the resulting effect on your health and appearance.
Quick facts about skin cancer treatment:
- Treatment of skin cancer, much like any form of cancer, may require surgery to remove cancerous growths
- Your plastic surgeon can surgically remove cancerous and other skin lesions using specialized techniques to preserve your health and your appearance
- Although no surgery is without scars, your plastic surgeon will make every effort to treat your skin cancer without dramatically changing your appearance
- For some people, reconstruction may require more than one procedure to achieve the best results
Depending on the size, type and location of the lesion, there are many ways to remove skin cancer and reconstruct your appearance if necessary.
Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedures. The choices include local, intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Step 2 – Removal
A small or contained lesion may be removed with excision — a simple surgical process to remove the lesion from the skin. Closure is most often performed in conjunction with excision.
Skin cancer can be like an iceberg. What is visible on the skin surface sometimes is only a small portion of the growth. Beneath the skin, the cancerous cells cover a much larger region and there are no defined borders. In these cases, a specialized technique called Mohs surgery may be recommended.
Your plastic surgeon may order a frozen section. In this procedure, the cancerous lesion is removed and microscopically examined by a pathologist prior to wound closure to ensure all cancerous cells have been removed.
The goal is to look for a clear margin — an area where the skin cancer has not spread. If clear margins are found, the resulting wound would be reconstructed. If clear margins are not present, your plastic surgeon will remove more tissues until the entire region has a clear margin.
Step 3 – Reconstruction
A large lesion or one that has been removed with frozen sections can be reconstructed with a local flap. A flap may also be necessary where excision may result in a disfiguring appearance. A local flap repositions healthy, adjacent tissue over the wound. A suture line is positioned to follow the natural creases and curves of the face if possible, to minimize the appearance of the resulting scar.
A skin graft, healthy skin removed from one area of the body and relocated to the wound site, may also be applied.
Step 4 – See the results
After your skin cancer has been removed and any primary reconstruction is completed, a dressing or bandages will be applied to your incisions.
Results and outlook
Your plastic surgeon can treat your skin cancer by surgically removing cancerous skin and reconstructing a more normal appearance. But some forms of skin cancer require additional treatment such as radiation therapy. Your physician will advise you about any follow-up treatment recommendations.
Reconstruction can restore a more natural appearance, but no reconstruction is perfect. Visible scars will always remain at incision sites. You may also expect textural, color or other visible differences of the skin in reconstructed areas. In some cases treating your skin cancer can be disfiguring to your appearance. Although every effort is made to restore your appearance as closely and naturally as possible, the most important factor is that your skin cancer is effectively cured.