Skin Cancer Excision

Overview

Skin cancers are generally categorized into three main types: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. Each type requires different treatment approaches, and a plastic surgeon can play a pivotal role in their management. Plastic surgeons not only remove cancerous tissue but also focus on reconstructing the affected areas to optimize cosmetic outcomes.

Types of Skin Cancer and Their Treatments

Basal Cell Carcinoma (BCC):

• Presentation: BCC is the most common type of skin cancer, typically appearing as a flesh-colored, pearl-like bump or a pinkish patch of skin.
• Treatment: Treatment often involves surgical removal using techniques like excision with frozen section. This precise method allows for in-theatre histology assessment to ensure that only cancer-free tissue remains, minimizing damage to surrounding healthy tissue. This approach is particularly suitable for cosmetically sensitive areas like the face.

Squamous Cell Carcinoma (SCC):

• Presentation: SCC appears as a firm, red nodule or a flat lesion with a scaly crust.
• Treatment: Treatment involves surgical excision to remove the tumor and a margin of healthy tissue to ensure complete removal. For large tumors or those in sensitive areas, reconstructive techniques such as skin grafts or local flaps may be used to repair the defect after removal.

Melanoma:

• Presentation: Melanoma is the most aggressive form of skin cancer, originating from pigment-producing cells (melanocytes). It often presents as an unusual mole or dark spot that changes in size, shape, or color.
• Treatment: Treatment depends on the stage of the melanoma and may include surgical excision with wide margins to remove the tumor and surrounding tissue. Reconstruction after melanoma surgery may involve complex techniques such as skin grafts, tissue expansion, or flap surgery to restore function and aesthetics, especially if large areas are affected.

Role of Plastic Surgery in Skin Cancer Management

Reconstruction: Plastic surgeons are trained in techniques to reconstruct defects resulting from skin cancer removal while optimizing cosmetic outcomes. This can involve simple closure techniques for smaller lesions or more complex reconstructive methods for larger or cosmetically sensitive areas.
Cosmetic Considerations: Plastic surgeons prioritize both the removal of cancerous tissue and the preservation of aesthetics, especially in highly visible areas like the face. Techniques such as Mohs surgery and other tissue-sparing approaches are favored to minimize scarring and maximize cosmetic results.
Follow-Up Care: Plastic surgeons play a crucial role in post-operative care, including scar management and aesthetic refinement to help patients achieve the best possible cosmetic outcome after cancer treatment.