Skin Cancer Reconstruction

Learning that you have a skin cancer can be difficult news. When it is in a cosmetically sensitive area on your face, preserving normal tissue and restoring a natural appearance is imperative. Excision and reconstruction of a skin cancer can then be performed by Dr. Melyssa Hancock and Dr. Nathan E. Nachlas, Facial Plastic Surgeons Board-Certified by the American Board of Otolaryngology and Fellowship-Trained by the American Board of Facial Plastic and Reconstructive Surgery. They have performed an abundant number of reconstructive procedures and their skills in repairing facial defects are second to none.

Frequently Asked Questions

There are several different types of skin cancers. The three most common forms of skin cancer include melanoma, basal cell carcinoma, and squamous cell carcinoma. Awareness has increased for all types leading to earlier diagnosis and treatment. Nonetheless, the most important way to lower your risk of getting any kind of skin cancer is to protect yourself from exposure to the sun’s harmful ultraviolet (UV) rays. You should practice sun safety when outdoors by seeking shade, wearing protective clothing and sunglasses, and using a Broad Spectrum sunscreen with a Sun Protection Factor (SPF) of 30 or higher.  Avoid tanning beds, too! You should perform regular skin checks on yourself and family by looking for moles and other skin changes.

In general, there are 2 technical approaches to the removal of skin cancer when on the head and neck:

Mohs Surgery: Mohs surgery, also known as Mohs Micrographic Surgery, is a surgical technique used to treat skin cancer. This type of surgery is used to treat non-melanoma skin cancers, including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), as well as some types of melanomas. It is typically done by a specialized dermatologist who has specific training in Mohs Micrographic Surgery.
Standard Excision: This refers to the excision of the skin cancer as well as an area of normal tissue surrounding it. The amount of normal tissue also excised with the cancer depends on the size, location, and type of skin cancer. This method may be appropriate for some types and locations of skin cancers, but is often not the preferred method if the skin cancer is near certain important facial structures such as the nose, lips, or eyes.

Following excision of the skin cancer by either of the above methods, skin cancer reconstruction can be performed. Reconstructive surgery may be performed under local anesthesia, for smaller areas, but may require intravenous or general anesthesia, if the defect is larger or in a more complex area. Regardless of the type of anesthesia, skin cancer reconstructive procedures are generally outpatient procedures.

Through plastic surgery, cancerous skin growths can be surgically removed. Furthermore, plastic surgeons can do this in a way that maintains function and provides the most pleasing appearance possible. In treating skin cancer, Dr. Hancock and Dr. Nachlas often team up with a Mohs surgeon who performs the excision while Dr. Hancock or Dr. Nachlas performs the reconstruction. These two tasks can be completed on the same day. Dr. Hancock and Dr. Nachlas use the latest techniques to restore soft tissue defects to an appearance and function that is as close as possible to their pre-injury state.

After skin cancer is removed via standard excision or Mohs surgery, surgical reconstruction of the skin is necessary in order to close and repair the wound. Facial defects are very complex for both functional and aesthetic reasons. Skin cancer reconstruction is a general term that includes many different procedures, some of which are:

Sutures: This technique uses only stitches to close and heal the wound.
Skin flap: Skin from the surrounding area (also known as a local flap) may be mobilized and modified to repair the wound.
Skin grafts: A skin graft is skin from another part of the body (such as behind the ear) that is excised and transferred to the wound to fill in the wound. This technique is used when the area of missing skin tissue is too large to be covered with a local skin flap.

Skin cancer reconstructive surgeries are generally performed on an outpatient basis, meaning that you will be discharged on the day of surgery.  Your doctor will likely prescribe a course of antibiotics to prevent infection, especially if you had a skin flap or skin grafting procedure. In most situations, sutures, if present, are removed within the first week after surgery. Additional wound care may be needed for up to 2 weeks after surgery depending on the exact reconstruction methods used. It can take several weeks for all the swelling to resolve and up to several months for all the healing to occur. Dr. Hancock and Dr. Nachlas personalize the reconstructive approach for each patient and will give more specific recovery expectations during your visit.


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