Skin Cancer Reconstruction 

Understanding Skin Cancer 

Skin cancer is generally caused by exposure to ultraviolet (UV) light, particularly from the sun.   People with lighter-skin types are usually more susceptible to skin cancers caused by harmful UV rays from the sun.  Therefore, these cancers often occur on sun-exposed areas of the face and neck.  However, in some cases, skin cancers can develop in areas that are not exposed to the sun, particularly in people with dark-skin tones.  During a physical examination with your doctor, suspicious lesions may be biopsied for examination under the microscope, which can provide a diagnosis. 
There are three major types of skin cancer (in order of aggressiveness): basal cell carcinoma, squamous cell carcinoma, and melanoma.  Basal cell carcinoma (BCC) is the most common form of skin cancer, and also typically the least likely to spread to distant parts of the body (metastasis).  Squamous cell carcinoma (SCC) is the second most common type of skin cancer.  It can be more aggressive than BCC, but also has a low potential for metastasis.  Both BCC and SCC are very common and usually very treatable. Melanoma is not as common as BCC or SCC, but can be much more aggressive and is more likely to metastasize, i.e., spread to other parts of the body.

Understanding the Surgery

There are many different methods of treating skin cancers.  Treatment of skin cancer normally involves physically removing the lesion, oftentimes with surgery that can be performed by your facial plastic surgeon or dermatologist.  With some cancers, curettage and electrodessication can be an option for treatment.  This involves removing the tumor from the skin with a sharp curette and then using an electric current to destroy the remaining cancer cells in the wound.  Another option for treatment of skin cancer is Mohs surgery, which is performed by a dermatologist with special training.  This procedure involves stepwise removal of skin followed by immediate examination under the microscope until all of the cancer is removed.   Other treatment options include immunotherapy, targeted therapy, chemical peel, radiation therapy, chemotherapy, or photodynamic therapy.  In advanced cases, it may be required to use multiple methods to treat the cancer.

What to Expect After the Surgery

Many skin cancers can be treated in a clinic setting, allowing you to go home immediately after treatment.  In advanced cases, hospital admission may be required, but this is unusual.  Your surgeon will give you directions on how to care for your wound.   You will likely have to return to the clinic in about a week to have sutures removed if your surgeon placed non-absorbable sutures.  The scar can take up to a year to fully mature, so if things don’t look exactly the way you expected, be sure to talk to your surgeon, but keep in mind that your body requires a great deal of time to completely heal.

Medical content written by the AAFPRS Multimedia Committee
Medical content reviewed/approved by Dr. Samuel M. Lam and Dr. Albert J. Fox