In my practice, I see several patients a week for reconstructive surgery following the removal of skin cancer, normally from the face, neck or scalp. Because facial plastic and reconstructive surgery is my specialty, patients many times opt to have the surgical closure performed in our office to obtain the best possible outcome in terms of the appearance of the closure. There are many specialized methods I incorporate when performing a closure, and the method chosen will ultimately depend on the location and nature of the defect. Reconstructive surgery takes into account the principles of cosmetic surgery, and the two cannot be considered entirely separate practices. The primary difference is that when performing reconstructive surgery, the surgeon is correcting a defect in the skin, and the aim is to make the final outcome look as natural and “normal” as possible. As well, the goal is to restore functionality when the skin cancer has compromised functionality.
The most common types of skin cancer that affect millions of Americans every year are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). While these cancers are normally not life threatening (unlike melanoma), they can be extremely invasive, and if left alone may locally spread, causing many issues for the patient. In the case that a skin cancer has become invasive and spreads, the entire cancer must be removed, and often times this requires removing a large amount of skin. In this case, it is the goal to replace any missing tissue with similar tissue from a similar area of the face. The goal is to blend the incisions with the natural creases of the face so that the resulting scar is as imperceptible as possible. Surgical techniques rely on the principles of “subunits” of the face, and the surgeon aims to perform the closure at the junction between subunits when the defect involves a wider area of tissue.
Reconstructive surgery, especially when following skin cancer removal, is challenging and requires an experienced surgeon who can implement various surgical techniques in order to create the best possible outcome for the patient. Well after the closure is performed, I continue to see my patients for regular follow up visits so I can further work with them throughout the healing process. If you need to have reconstructive surgery, make sure to consult with an experienced surgeon who is thoroughly trained and experienced.
