CONSULTANT PLASTIC SURGEON
SKIN CANCER REMOVAL
What is skin cancer removal?
A cancer diagnosis is very difficult to accept. Understanding that treating your skin cancer may result in scars or disfigurement can also be troubling. Dr Ricardo understands your concerns and will guide you through treatment and explain the effect on your health and appearance.
Skin cancer, much like any form of cancer, may require surgery to remove the cancerous growth. Dr Ricardo can surgically remove cancerous and other skin lesions using specialized techniques to preserve your health and your appearance. Although no surgery is without scars, he will make every effort to treat your skin cancer without dramatically changing your appearance.
"Surgeons who have the necessary training, expertise, and experience in reconstructive surgery are fit to perform cosmetic surgeries with excellent outcomes. Those surgeons only trained in aesthetic procedures will have much more difficulty doing the same. The more tools and training in plastic surgery the surgeons have, the more qualified they are! "
What should I expect during a consultation for skin cancer removal surgery?
It will be clarified what approach is best for you. Alternative and additional treatments may be considered, once Dr Ricardo understands your medical condition. It is important to be completely honest during the consultation and be prepared to discuss medical conditions, drug allergies and medical treatments, current medications, vitamins, herbal supplements, alcohol, tobacco and drug use, and previous surgeries.
Dr Ricardo will also evaluate your general health status and any pre-existing health conditions or risk factors, take photographs, discuss the approach to your surgery, including the type of procedure or combination of procedures and discuss any risks or potential complications.
The success and safety of your skin cancer removal surgery depend very much on your complete candidness during your consultation. It's very important to understand all aspects of your procedure. It's natural to feel some anxiety; it's a bit of preoperative stress. Don't be shy about discussing these feelings with Dr Ricardo.
How should I prepare for skin cancer removal surgery?
In preparing for skin cancer removal surgery, you may be asked to get lab testing or a medical evaluation, take certain medications or adjust your current medications, stop smoking in advance of surgery and avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding.
Your surgery will be performed in an accredited hospital and is usually performed on an outpatient basis unless you and Dr Ricardo have made other plans for your immediate postoperative recovery. You must arrange for a friend or family member to drive you to and from surgery and to stay with you the first night following surgery.
Dr Ricardo and the entire staff will provide thorough preoperative instructions and answer any questions you may have. The goal is to make your surgical experience as easy, comfortable, and safe as possible.
What are the steps of a skin cancer removal procedure?
Depending on the size, type, and location of the lesion, there are many ways to remove skin cancer and reconstruct your appearance if necessary. The following are some of the possible procedure steps involved in skin cancer removal surgery:
Step 1 – Anaesthesia
Medications are administered for your comfort during surgical procedures. The choices include local, intravenous sedation, and general anaesthesia. Dr Ricardo 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. The 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, Dr Ricardo may use frozen sections during the removal of your skin cancer to discover and define the borders of the cancerous area. Frozen sections are small parts of the tissue that are removed and immediately sent to the pathologist. These pieces of tissue are then quickly frozen so that he or she can examine them for cancer cells at the time of removal of cancer. This helps Dr Ricardo to make sure that all of the cancer has been removed.
Alternatively, Dr Ricardo may recommend a specialized technique called Mohs surgery. This procedure may be performed by him, or you may be referred to a dermatologic surgeon that specializes in this procedure. Mohs surgery is a procedure that is performed through the use of multiple specially prepared frozen sections. The goal is to look for a clear margin – an area where skin cancer has not spread. If clear margins are found, the resulting wound can be reconstructed. If clear margins are not present, the surgeon will remove more tissue until the entire region has a clear margin.
Step 3 – 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 (also called "adjacent tissue rearrangement"). Healthy, adjacent tissue is repositioned over the wound. The suture line is positioned to follow the natural creases and curves if possible, to minimize the obviousness of the resulting scar. Several variations of local flap procedures may be used to reconstruct a specific area of the face or body and will describe these techniques and resulting scar patterns that are tailored to your specific anatomy. More complex wounds may require more than one procedure (or "stage") to achieve a satisfactory result.
Dr Ricardo 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.
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.
What should I expect during my recovery after skin cancer removal?
During your skin cancer removal surgery recovery, incision sites may be sore, red, or drain small amounts of fluid. 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 Dr Ricardo. Make certain to keep your incision sites clean and well protected from potential injury and try to limit movement that may stress your wound and your sutures.
Healing will continue for many weeks or months as incision lines continue to improve. It may take a year or more following a given procedure 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. Sun exposure may increase the risk of the development of skin cancer in another region of your body.
What results should I expect after skin cancer removal?
Dr Ricardo can treat your skin cancer by surgically removing cancerous skin and closing the resulting wound. Some forms of skin cancer require additional treatment such as radiation therapy. He will advise you about any postoperative treatment recommendations. Follow-up is extremely important for early detection of any new skin lesions.
Reconstruction closes the skin cancer defect, but no reconstruction is perfect. Visible scars will always remain at incision sites. You may also see a textural, colour or other visible differences of the skin in reconstructed areas. 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 removed. Dr Ricardo will give you specific instructions on how to care for yourself.