Skin Cancer Reconstruction Philadelphia
Skin cancer is the most common form of cancer in the United States and in the greater Delaware area. Though everyone is at risk for skin cancer, you are at greater risk if you are fair skinned, have a family history of skin cancer or spend a lot of time outdoors. Risk also increases with age.
- Basal Cell Carcinoma – This is the least dangerous form of skin cancer. It grows slowly and rarely spreads.
- Squamous Cell Carcinoma – This form is more likely to spread and become life threatening if not treated.
- Malignant Melanoma – Melanoma commonly spreads and can be deadly. A new mole or a change in existing mole can be a warning sign for melanoma.
According to the American Cancer Society, there will be 1 million new cases of skin cancer this year, with the three most common types being Basal Cell Carcinoma, Squamous Cell Carcinoma and Malignant Melanoma. Basal Cell and Squamous Cell Carcinomas are usually localized and rarely spread to other parts of the body. Malignant Melanoma is more serious as it has a propensity to metastasize (spread) to other areas of the body.
It is estimated that 93% to 97% of all skin cancer occur on a highly visible part of the body such as the head, face, ears, neck, hands, and arms. It’s not hard to understand why this is the case, considering that these are the parts of the body which typically receive the most sun exposure.
Early diagnosis is important for long-term health. By paying close attention to your skin and existing moles, sores that are taking a long time to heal, new lumps or changes in color or texture, you may save your life.
- Minimize sun exposure
- Wear sunscreen daily
- Full body skin exams by your dermatologist yearly, or more frequently if you have a personal or family history of skin cancer
Our practice utilizes a multi-specialty team approach in treating skin cancer. By teaming up with dermatology colleagues in treating skin cancer, the patients are afforded the best possible treatment and outcomes. The dermatologist will diagnose and treat the specific skin cancer, and your surgeon will provide facial plastic surgery expertise to reconstruct any defect which is left after complete skin cancer removal. This team approach allows all patients the best possible cure rates, while also giving patients the most aesthetically pleasing results as well.
While certain types of skin cancer can be treated with cryotherapy (freezing), lasers, electrodessication and curettage, and even topically applied chemotherapy, others require surgical excision.
Often, the best way to accomplish skin cancer excision while preserving as much normal tissue as possible in highly visible areas is to undergo Mohs surgery. This procedure is most commonly used to treat Basal Cell and Squamous Cell Carcinomas. Mohs surgery is often suggested when it is critical to preserve as much healthy tissue as possible of such areas as the face, ears, nose, and lips. Mohs skin cancer surgery is then followed by careful reconstructive surgery to repair the defect (hole) and to yield an aesthetically pleasing result.
Mohs micrographic surgery is a highly specialized surgical technique for skin cancer removal. Developed by Dr. Frederick Mohs in the late 1930s, the technique is now practiced throughout the world. Mohs surgery allows for the immediate microscopic examination of the removed cancerous tissue. This eliminates days of waiting for a pathology report from an outside lab. The cancer is shaved off one level (layer) at a time and is immediately examined under the microscope. If cancer extension is seen at the margins, then additional tissue layers are shaved off. This process is repeated until all the margins are clear. This method has the highest cure rate while preserving healthy tissue and maximizing cosmetic results. A Mohs surgeon is a dermatologist who has received at least one year of additional specialized training in the surgical removal of skin cancer lesions.
Facial reconstruction requires a great deal of personalization. A highly trained plastic surgeon will choose from many different types of flap or graft techniques to create the most natural results possible. The reconstructive technique selected to repair your skin cancer defect will depend on a variety of factors, including the amount of tissue removed during your Mohs surgery, your cancer surgeon’s input, and the current condition of your skin and underlying tissue.
The removal of a skin cancer from your face is a traumatic experience and it is normal to be concerned about how your face will look after everything has healed. Although no one can re-create your original face, Delaware area plastic surgeons strive to use their extensive experience to help give you a reconstructive result that looks as natural as possible.
Cosmetic surgeons employ special preoperative planning to select the most appropriate reconstructive option. The goal is to provide the best reconstructive option that provides the least down-time and maximizes function and aesthetics.
The following options are utilized on a routine basis:
- Primary closure of the defect
- Skin grafts
- Local flaps
Local flaps are mainly utilized for facial and nasal reconstruction after Mohs skin cancer removal. Local tissue allows the most aesthetically pleasing outcomes. The results are excellent after the scars mature. Patients have to use sunscreen and avoid direct sun exposure for at least one year. Here are some examples of local flaps:
- Bilobed flap
- Nasolabial flab
- Paramedian forehead flap