What is Skin Cancer Removal?

A cancer diagnosis is very difficult to accept. Understanding that treating your skin cancer may result in scars or disfigurement can also be troubling. Your plastic surgeon understands your concerns and will guide you through treatment and explain the resulting effect on your health and appearance.

Skin cancer, much like any form of cancer, may require surgery to remove cancerous growths. Your plastic surgeon can surgically remove cancerous and other skin lesions using specialized techniques to preserve your health and your appearance.

Although no surgery is without scars, your plastic surgeon will make every effort to treat your skin cancer without dramatically changing your appearance.

Skin cancer words to know

  • Basal cell carcinoma: The most common form of skin cancer. Occurs in the epidermis. These growths are often round and pearly or darkly pigmented.
  • Cancer: The uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.
  • Epidermis: The uppermost portion of skin.
  • Excision: A simple surgical process to cut the lesion from the skin.
  • Frozen section: A surgical procedure in which the cancerous lesion is removed and microscopically examined by a pathologist prior to wound closure to ensure all cancerous cells have been removed.
  • General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
  • Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
  • Local flap: A surgical procedure used for skin cancer in which healthy, adjacent tissue is repositioned over the wound.
  • Melanoma: A skin cancer that is most often distinguished by its pigmented blackish or brownish coloration and irregular and ill-defined borders is the most serious form of skin cancer. It occurs in the deepest portion of the epidermis, and for this reason, melanoma is the most likely form of skin cancer to spread quickly in the skin and to other parts of the body.
  • Mohs surgery: A surgical procedure that’s used when skin cancer is like an iceberg. Beneath the skin, the cancerous cells cover a much larger region and there are no defined borders.
  • Nevi: A mole.
  • Skin graft: A surgical procedure used for skin cancer. Healthy skin is removed from one area of the body and relocated to the wound site. A suture line is positioned to follow the natural creases and curves of the face if possible, to minimize the appearance of the resulting scar.

What to expect during surgery

Depending on the size, type and location of the lesion, there are many ways to remove skin cancer and reconstruct your appearance if necessary.

The following are some of the possible procedure steps involved in skin cancer removal surgery:

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedures. The choices include local, intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 2 – Removal

A small or contained lesion may be removed with excision – a simple surgical process to remove the lesion from the skin. Closure is most often performed in conjunction with excision.

Skin cancer can be like an iceberg. What is visible on the skin surface sometimes is only a small portion of the growth.

Beneath the skin, the cancerous cells cover a much larger region and there are no defined borders. In these cases, a specialized technique called Mohs surgery may be recommended.

During this procedure, your plastic surgeon may order a frozen section. During this step, the cancerous lesion is removed and microscopically examined by a pathologist prior to wound closure to ensure all cancerous cells have been removed.

The goal is to look for a clear margin – an area where the skin cancer has not spread. If clear margins are found, the resulting wound would be reconstructed. If clear margins are not present, your plastic surgeon will remove more tissues until the entire region has a clear margin.

Excisional Surgery

Using a scalpel, the physician removes the entire growth along with a surrounding border of apparently normal skin as a safety margin. The skin around the surgical site is closed with stitches, and the tissue specimen is sent to the laboratory to verify that all cancerous cells have been removed.

Step 3 – Reconstruction

A skin cancer lesion that is particularly large, is being removed with frozen sections or is likely to cause disfigurement may be reconstructed with a local flap.

Healthy, adjacent tissue is repositioned over the wound. The suture line is positioned to follow the natural creases and curves of the face if possible, to minimize the obviousness of the resulting scar.

Your surgeon may choose to treat your wound with a skin graft instead of a local flap. A skin graft is a thin bit of skin removed from one area of the body and relocated to the wound site.

Step 4 – See the results

After your skin cancer has been removed and any primary reconstruction is completed, a dressing or bandages will be applied to your incisions.

After Surgery

During your skin cancer removal surgery recovery, incision sites may be sore, red, or drain small amounts of fluid following surgery.

  • It is important to follow all wound care instructions such as cleansing and applying topical medications exactly as directed
  • You will be able to return to light activity as instructed by your surgeon
  • Make certain to keep your incision sites clean and well protected from potential injury
  • Try to limit movement that may stress your wound and your sutures

Limitations and Risks

You will have to decide if the risks and potential complications of skin cancer removal surgery are acceptable.

You will be asked to sign consent forms to ensure that you fully understand the procedure.

The risks include:

  • Allergies to tape, suture materials and glues, blood products, topical preparations, or injected agents
  • Anesthesia risks
  • Excessive bleeding
  • Change in skin sensation
  • Damage to deeper structures – such as nerves, blood vessels, muscles – can occur and may be temporary or permanent
  • Infection
  • Poor healing of incisions
  • Possibility of revision surgery
  • Recurrence of skin cancer
  • Systemic spread of skin cancer
  • These risks and others will be fully discussed prior to your consent. It’s important that you address all your questions directly with your plastic surgeon.

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