In the U.S., skin cancer is the most common type of cancer, according to the National Institutes of Health. While anyone can develop skin cancer, there are a number of factors that increase your risk, including skin type, age and habits. If a doctor determines that you have cancer on the skin, the tumor is usually removed to prevent it from spreading. In a lot of cases, reconstructive surgery is desired after the tumor removal to conceal any scars or other defects.
Types of Skin Cancer
There are several different types of skin cancer and some are more common than others. Some forms of skin cancer are more dangerous than others. The two most common types of cancer on the skin are basal cell carcinoma and squamous cell carcinoma. Basal cell cancer typically develops on areas of the skin that see frequent sun exposure, such as the face. Squamous cell cancer can develop on areas of the skin that don’t get as much sun exposure, such as the legs. People with lighter skin have an increased risk of developing either type of cancer.
Melanoma is the third type of malignant skin cancer. It is less common than basal cell or squamous cell cancers, but is also more dangerous. Melanoma develops in the cells that produce pigment in the skin. Detecting melanoma early enough is critical to stopping its spread to other areas of the body. With early detection, the cancer is curable.
Surgery to Remove the Cancer
The type of surgery used to remove the cancer depends on the size and type of skin cancer a person has. One option is excisional surgery, which removes the tumor and an area of skin around it. The skin is typically numbed first, and the tumor and margin removed using a scalpel. The surgeon will look at the extra skin removed under a microscope to make sure it is free of cancer.
Another surgical option is Mohs surgery. Mohs is typically used for basal cell and squamous cell cancers. It’s one of the most effective ways to remove a tumor and the method that leaves the least amount of scarring or disfigurement. During the procedure, the area is numbed, then the surgeon scrapes away a thin layer of the tumor. The layer is looked at under a microscope to see if cancer is present. The surgeon typically continues to remove thin layers of tissue, until the sample under the microscope is completely free of cancer.
Other surgical options include cryosurgery, which freezes the cancer. It’s typically most effective if the tumor is small. Smaller tumors can also be removed using a curette, a metal tool that scoops out the tumor.
After the tumor is removed, a patient may need reconstructive surgery to repair the area or reduce the appearance of scars. Often, the reconstructive surgery will be performed on the same day as the removal to reduce the risk of infection in the area and to improve the chances of healing. Other times, the area may first need to heal before reconstruction is performed.
A surgeon may reconstruct the area using a flap, or by moving healthy tissue next to the wound over the area of the wound, to conceal it. The surgeon will then typically arrange the sutures so that the line follows the natural curve of the area, reducing the appearance of scars. In some cases, a surgeon might use a skin graft, transferring skin from one area of the body to the affected area.
While many patients are able to return to their daily activities within a few days after reconstructive surgery, it can take up to a year for final results to appear. As the area heals, the incision will become less prominent and the graft will become less apparent.
During recovery, it’s important that a patient not bump or irritate the area. If the tumor and reconstruction was on the face, it’s typically a good idea to avoid pulling clothing on over the head during healing to avoid hitting the wound. Certain activities, such as strenuous exercise, should be limited until a patient gets the go-ahead from the surgeon.
Since sun exposure is one of the leading causes of skin cancer, patients need to be cautious about time spent in the sun after the surgery. Wearing sunscreen daily is a must, as is avoiding spending a lot of time outdoors when the sun is at its most intense, usually between 10 am and 4pm.
If you have been diagnosed with skin cancer and want to learn more about your options for reconstructive surgery, contact Dr. Kyle S. Choe for a consultation. Dr. Choe is a board certified facial plastic surgeon who has performed reconstructive surgery on numerous skin cancer patients. Contact The Choe Center for Facial Plastic Surgery in Virginia Beach at (757) 389-5850 for a consultation.