Facial Skin Cancer Reconstruction

Serving Chattanooga, Tennessee

Melanoma and skin cancer prevention is a focus of this month’s Women’s Way. Although the prevention of skin cancer is key, plastic surgeons are significantly concerned with the reconstruction of patients who have been treated for skin cancers. The great majority of these aesthetically sensitive reconstructions are performed on the head and neck. At times, plastic surgeons both remove the cancer and reconstruct the site at the same time. We may also carry out a reconstruction after a cancer surgeon, or dermatologist has removed a significant cancer.

All skin cancers are not alike. Some, like melanoma, can be very deadly while others are more slow growing and rarely travel (or metastasize) to lymph nodes or other body organs. Early detection is fundamental to limiting the damage a skin cancer can cause.

Once a suspicious area is identified, a biopsy or sample is sent to a pathologist. This specialized physician has the training to identify the specific cancer, and a plan can then be developed for its treatment. Usually the plan calls for a complete removal of the cancer. This is where the plastic surgeon may come in.

Often we are asked to remove cancers in areas that are aesthetically sensitive like the nose or eyelid. Many times, the edges of the cancer can be checked immediately to determine if all the cancer has been removed. A technique called a frozen section or a dermatologic process called Moh’s surgery can accomplish this. Regardless of the technique, the goal is to remove the cancer completely and thereby limit recurrence of the cancer.

Plastic surgeons can then study the defect created by the removal of the cancer and develop a plan for its reconstruction. Plastic surgeons adhere to the principle of the reconstructive ladder for most problems. That means - do the simplest thing first. We also always prefer to replace an area lost to skin cancer with a reconstruction of similar skin and soft tissue quality.

The simplest means of skin cancer reconstruction is a direct closure. Here, the edges of the area that has been removed are brought together carefully and usually as a line. It gets more complicated from here. Skin grafts have a long and useful history in facial plastic surgery. Employed in the correct situation, they can produce excellent aesthetic results. “Flap” is a term that is synonymous with reconstructive plastic surgery. These ingenious tissue movement designs are crucial in a wide variety of reconstructions. Though most commonly used for cancers on the nose, they can be used everywhere on the face. They also range in complexity from minor immediate solutions to operations with multiple stages that can entirely reconstruct (for example) the nose from the ground up. Finally, at the top of the ladder, modern microsurgical techniques can move large blocks of muscle, skin, and fat from distant areas of the body to reconstruct devastating anatomic structural losses caused by large and invasive skin cancers.

    

Frequent skin evaluation, and common solar protection techniques are crucial in the battle against skin cancer. Should a cancer excision be needed, however, modern reconstructive techniques can provide a seamless and cosmetically reliable solution.

For more information on your facial reconstructive surgery visit the board certified surgeons of The Plastic Surgery Group or contact us today.