Also Serving Skin Cancer Reconstruction Patients in Everett & Bellingham
If you have a spot or lesion on your face, it could be skin cancer. Dr. Jonathan Grant can biopsy or excise these lesions to determine if they are benign or cancerous. The excised tissue can then be sent to a pathologist to obtain a tissue diagnosis.
If the tissue is found to be cancerous, Dr. Grant’s office will coordinate with another physician for what is called Mohs surgery. In that procedure, they remove a thin layer of cells and check them under the microscope for the presence of cancer. Thin layers continue to be removed until no more cancer is present. In this way, as many healthy cells as possible are preserved, minimizing the size of the skin cancer reconstruction area.
After Mohs surgery, Dr. Grant performs reconstruction in order to minimize scarring as much as possible. This can involve skin or cartilage grafts and rearrangement of nearby soft tissues.
At Cascade Facial Surgery, Dr. Grant treats every patient as a unique individual. No two skin cancer reconstruction surgeries are the same. Your surgical plan is designed specifically to provide you with the best possible result within the parameters of sound and safe medical practices. Dr. Grant’s training and experience as a reconstructive facial surgeon allow him to provide excellent results in skin cancer reconstruction.
Eighteen months ago I went to my regular dermatologist for a Mohs procedure. (A prior visit and biopsies of two right temple lesions were positive for basal cell cancer).... Read More »M.G.
Understanding the Skin Cancer Reconstruction Procedure
Dr. Grant will examine you during your consultation and discuss his recommended surgical plan for you.
Skin grafts or tissue grafts may be harvested from other parts of the body in order to restore the affected area to normalcy. Dr. Grant will tell you ahead of your surgery what areas of the body the grafts will be taken from.
The surgery can sometimes be done with local anesthetic alone, although sometimes IV anesthetic and sedation may be required. In some cases, general anesthesia may be required. Except in extreme cases, you will be able to go home on the same day as your surgery.
Recovering From Skin Cancer Reconstruction
You can expect to need some time off from work, but it will vary from patient to patient depending on severity. After all surgeries, there is some pain and swelling. Some patients also experience mild bruising. These symptoms are to be expected.
You can take pain medication, and we will give you instructions how to take care of your wounds during this time. Sleeping upright or with your head elevated for the first few nights will help to keep swelling to a minimum.
We will also provide instructions for protecting your skin from further incidents of skin cancer. Of course, wearing a strong sun block is very important, but you must also reapply it frequently and avoid tanning booths.
Skin Cancer Reconstruction FAQs
Who is a candidate for Skin Cancer Reconstruction?
Candidates for this surgery are those who have had skin cancer diagnosed and removed from the face, neck, or scalp and have been left with an unsightly wound, scar, or disfigurement.
What are the Different Types of Skin Cancer?
There are three main types of skin cancer:
- Basal cell carcinoma is the most common type, and it is also the easiest to treat. It typically only affects the top layers of skin and does not spread to the blood or lymph nodes.
- Squamous cell carcinoma can involve the middle layers of skin as well, and it can spread in the lymph nodes or blood, or grow into deeper tissues like bone.
- Melanoma is the most serious type. It carries the greatest risk for spread and can affect the body’s organs and systems away from the original skin cancer site.
What are the techniques used in skin cancer reconstruction?
There are four main techniques plastic surgeons use to restore the appearance and function of skin after Mohs surgery. The type chosen will depend upon how extensive your malignant lesion was, and how much tissue was removed to completely excise it.
Primary closure is a conservative approach that relies on your skin’s own recuperative powers. When the original lesion is minor, the skin can efficiently close the wound, often with the use of sutures.
More extensive defects that are adjacent to ample amounts of tissue can benefit from the local flap closure technique. As the name suggests, the nearby healthy tissue is used to create a “flap” to cover the gap or indentation left from Mohs surgery.
When a flap closure is not possible, skin grafting is an option. Skin is removed from an inconspicuous area of the body and laid over the skin defect, where it will join with tissue as the incisions heal.
When cartilage has been removed or damaged during Mohs surgery, structural grafting may be required. Cartilage below the skin is repaired, in addition to surface defects. This is most common when a lesion has been removed from the ear or nose.
Is this an outpatient procedure?
It can be, but this is another situation in which the severity of the original lesion will determine the course of action chosen by your surgeon. Smaller defects can be reconstructed during an in-office procedure, using light sedation. Experienced Mt. Vernon facial plastic surgeon Dr. Jonathan Grant is able to perform this type of procedure in as quickly as a half hour. Complex cases involving skin grafting or structural grafting will require a hospital stay and either general anesthesia or “twilight” anesthesia administered intravenously. This type of surgery could last several hours. Some patients require more than one operation to fully reconstruct the affected area.
What type of scarring will there be?
If your skin cancer surgery involved removal of a large malignancy, there will be noticeable scarring. How extensive it will be can be hard to predict, and depends in part on individual characteristics that are unique to each patient. For example, the way your body heals wounds is governed largely by your genetic inheritance. Some patients are more predisposed to develop keloids, scars that tend to be raised and often wide. Skilled surgeons performing a Mohs procedure take care to place incisions in areas that will be less noticeable, such as natural skin creases or wrinkles. Mohs surgery’s technique of removing one thin layer of skin at a time, and checking each layer for the presence of cancer cells before going deeper, helps reduce the overall amount of scarring.
You as a patient will also play a role in minimizing the appearance of scars, by limiting sun exposure, applying prescribed topical medications and following your surgeon’s post-operative instructions. Fortunately, you will not have to live with the scars you first notice soon after surgery - all scars gradually improve in appearance over the course of a year.