Skin Cancer Removal and Reconstruction

Skin Lesion Removal at Hedden & Gunn Plastic Surgery

According to the American Cancer Society, skin cancer is the most common type of cancer, accouting for half of all cancers in the United States. Fortunately, most skin cancers are highly curable with early detection and treatment.

The surgeons at our Birmingham, Alabama plastic surgery center use specialized techniques for Skin Cancer Removal to remove cancerous and other skin lesions while preserving your health and appearance.

Your Skin Cancer Removal Consultation

By choosing a member of the American Society of Plastic Surgeons (ASPS) for your skin cancer removal procedure, you can be assured that you are choosing a highly-trained, board-certified plastic surgeon. ASPS Member Surgeons must meet rigorous standards for training, ethics, physician practice and research in plastic surgery.

The success and safety of your skin cancer removal procedure depends very much on your complete candidness during your consultation. You will be asked a number of questions about your health, desires and lifestyle. Be prepared to discuss:

• Your type of skin cancer.
• Medical conditions, drug allergies and medical treatments.
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs.
• Previous surgeries.
• The likely outcomes of your treatment and any risks or potential complications.

Your skin cancer removal surgeon will also:

• Evaluate your general health and any pre-existing health conditions or risk factors.
• Examine your skin.
• Take photographs.
• Discuss your options and recommend a course of treatment.
• Discuss the likely outcomes of surgery and any risks or potential complications.

Be sure to ask questions at your consultation. It is very important to understand all aspects of your skin cancer removal procedure. It's natural to feel some anxiety. Don't be shy about discussing these feelings with your plastic surgeon.

Skin Cancer Removal Risks and Safety Information

You will have to decide if the risks and potential complications of skin cancer removal are acceptable. These risks include:

• Allergies to tape, suture materials and glues, blood products, topical preparations or injected agents.
• Anesthesia risks.
• Excessive bleeding.
• Change in skin sensation.
• Damage to deeper structures (such as nerves, blood vessels and muscles), which may be temporary or permanent.
• Infection.
• Poor healing of incisions.
• Possibility of revision surgery.
• Recurrence of skin cancer.
• Systemic spread of skin cancer.

Skin grafts have an added risk that the graft may not "take" and additional surgery may be necessary to close the wound.

These risks and others will be fully discussed prior to your consent. It is important that you address all of your questions directly with your plastic surgeon. You will be asked to sign consent forms to ensure that you fully understand the procedure.

Preparing for Skin Cancer Removal Surgery

In preparing for skin cancer removal, you may be asked to:

• Get lab testing or a medical evaluation.
• Take certain medications or adjust your current medications.
• Stop smoking.
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements, as they can increase bleeding.

Your plastic surgeon also will discuss where your procedure will be performed. Skin cancer surgery may be performed in a treatment room, accredited office-based surgical facility, licensed ambulatory surgical center or hospital. If your procedure is performed with sedation, be sure to arrange for someone to drive you to and from surgery and stay with you for at least the first night.

Skin Cancer Procedures

Depending on the size, type and location of the lesion, there are many ways to remove skin cancer and, if necessary, reconstruct your appearance. Some forms of skin cancer require additional treatment, such as radiation therapy. This section covers some of the possible procedure steps involved in skin cancer removal surgery.

Anesthesia choices for skin cancer removal include local anesthesia, intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Skin Cancer Excision

A small or contained lesion may be removed with excision, a simple surgical process that is performed to remove the lesion from the skin. Closure is most often performed in conjunction with excision.

Skin Cancer Reconstruction

A skin cancer lesion that is particularly large, is being removed with frozen sections, or is likely to cause disfigurement may be reconstructed with a local flap.

Adjacent healthy tissue is repositioned over the wound. The suture line is positioned to follow the natural creases and curves of the face, if possible, to minimize the resulting scar.

Your surgeon may choose to treat your wound with a skin graft instead of a local flap. A skin graft is a thin bit of skin removed from one area of the body and relocated to the wound site.

Skin Cancer Removal Recovery

Your doctor will give you specific instructions on how to care for yourself. Following your physician's instructions is essential to the success of your skin cancer removal surgery and recovery.

After your skin cancer has been removed and any primary reconstruction is completed, a dressing or bandages will be applied to your incisions. Incision sites may be sore, red or drain small amounts of fluid.

It's important that the surgical incisions are not subjected to excessive force, swelling, abrasion or motion during the time of healing.

• It is important to follow all wound care instructions such as cleansing and applying topical medications exactly as directed.
• You will be able to return to light activity as instructed by your surgeon.
• Be sure to keep your incision sites clean and well-protected from injury.
• Try to limit movement that may stress your wound and your sutures.

Be sure to ask your plastic surgeon specific questions about what you can expect during your skin cancer removal recovery period.

• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery, and when will they be removed?
• Are stitches removed, and when?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?
• How long will it take before healing is complete?

Skin Cancer Removal Results

Skin cancer may reoccur. Once you have been diagnosed with skin cancer, you are at a higher risk of developing another skin cancer. Sun exposure may increase risk. It is important to discuss the signs of skin cancer with your physician, regularly perform self-examinations for suspicious lesions and schedule an annual skin cancer screening.

Your physician will advise you about any follow-up treatment recommendations.

Healing will continue for many weeks or months as incision lines continue to improve. It may take a year or more for incision lines to refine and fade to some degree. In some cases, secondary procedures may be required to complete or refine your reconstruction.

Sun exposure to healing wounds may result in irregular pigmentation and scars that can become raised, red or dark.

Visible scars will always remain at incision sites. You may also see textural, color or other visible differences of the skin in reconstructed areas. Treating skin cancer can be disfiguring in some cases. Your plastic surgeon will make every effort to treat your skin cancer without dramatically changing 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.

Skin Cancer Removal Words to Know

• Basal cell carcinoma: The most common form of skin cancer. Occurs in the epidermis. These growths are often round and pearly or darkly pigmented.
• Cancer: The uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.
• Epidermis: The uppermost portion of skin.
• Excision: A simple surgical process to cut the lesion from the skin.
• Frozen section: A surgical procedure in which the cancerous lesion is removed and microscopically examined by a pathologist prior to wound closure to ensure that all cancerous cells have been removed.
• General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
• Intravenous sedation: Sedatives administered by injection to help you relax.
• Local flap: A surgical procedure used for skin cancer in which adjacent healthy tissue is repositioned over the wound.
• Melanoma: The most serious form of skin cancer. Most often distinguished by its pigmented blackish or brownish coloration and irregular and ill-defined borders. Occurs in the deepest portion of the epidermis and, for this reason, is the most likely form of skin cancer to spread quickly in the skin and to other parts of the body.
• Nevi: A mole.
• Skin graft: A surgical procedure used for skin cancer. Healthy skin is removed from one area of the body and relocated to the wound site. 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.