By Plastic Surgery Center of Naples
Skin cancer is a very common problem. Half the population in America have at least one skin cancer by the time they’re 65. Skin cancers come in many different forms- some are more aggressive, some are localized, and some have the risk of spreading into other organs. While the most common skin cancers are primarily local, in general, we’re looking at basil cell carcinoma, squamous cell carcinoma and malignant melanoma.
Removal of skin cancer is most often necessary, and by default results in loss of tissue, therefore, you have a deficit. The question is, can this be closed easily or not? Simple skin cancers are often detected by your primary care provider or your dermatologist. However, more complicated skin cancers require significant closure or, otherwise, may cause a significant deformity or difficulty in healing. Plastic surgeons do closures that will help reduce deformity and scarring. Areas also need to be reconstructed or “rebuilt” to give back portions that have been resected. It is often not fully understood that the most difficult portion about skin cancer is often closing the defect, not just removing the tumor. Removing the tumor and ensuring clear margins obviously is important, and removing an inadequate amount of tissue is not helpful if margins are still positive for cancer. If one does not care what the result of the deformity looks like, or, if putting things back together is not important, then obviously a plastic surgeon is not necessary. The standard of care should consider what the result will be, which includes the appearance and function of the area.
Plastic surgeons are needed when there is a defect that is of more significant size or is in a complex area, which includes more difficult structures that must be put back together, or if a critical structure is exposed such as nerves, tendons, cartilage, bone, as well as areas involving critical complex structures, such as eyelids, nose, mouth, and ears. Other defects of the head and neck, and deformities involving hands and feet will most often require plastic surgery.
Sometimes areas can be reconstructed with direct closure, or a skin graft, however a “flap” may be a better choice which is a more advanced reconstruction, in which a live tissue transfer is required. This involves specialized knowledge and experience in vascular connections and how live tissue transfers can mend. It’s not as easy as placing a patch.
My daily routine as a plastic surgeon involves resection and reconstruction of cancers of critical structures. Immediate or delayed reconstruction may be done in an office setting with only local anesthesia or with specialized anesthetic techniques using tumescent anesthesia for larger areas, that otherwise, would have to be done in the surgery center setting or hospital setting. The best advice to give, is to get regular screenings, so that cancers are detected early.
The Plastic Surgery Center of Naples
860 111th Ave., N., Suite #6, Naples Florida, 34108
866-416-SKIN | www.SwedishDr.com