Skin Cancer

While early or pre-cancerous lesions can be safely removed during a quick office visit to the dermatologist, advanced cancers require surgical excision. After skin cancer, reconstructive surgery can help provide a more aesthetically pleasing appearance and help the patient feel a sense of closure. There are several different options for reconstruction, including Mohs surgery and excision. Our team will strive to preserve as much healthy tissue as possible and minimize scarring in every case. Contact Austin Face & Body today to learn more about your options after being diagnosed with skin cancer.

What is skin cancer?

Defined as an abnormal proliferation of cells, skin cancer occurs in three different iterations: basal cell carcinoma, squamous cell carcinoma, and melanoma.

Basal cell carcinoma: This type of cancer may appear early on as a flattened lesion that resembles a scar. It is most commonly caused by overexposure to the sun and is the most frequently occurring type of skin cancer.

Squamous cell carcinoma: Here, the lesion appears flat with a red crust or firm bump. This type of skin cancer is most often found in those with light pigmentation. Early diagnosis is important with SCC to keep it from spreading.

Melanoma: This type of cancer, while rare, is the most serious due to its propensity for spreading. It usually appears as a sudden growth or a mole that transforms. Melanoma can be caught early by using the ABCDE warning system (Asymmetry, Border, Color, Diameter, Evolving).

Why see a facial plastic surgeon for skin cancer? 

Once you’ve received a skin cancer diagnosis, you’ll also want to make an appointment with a facial plastic surgeon – before cancer treatment. 

While dermatologists and Mohs surgeons are specially trained to remove skin cancer, facial plastic surgeons know how to reconstruct your intricate facial features and ensure that you emerge from skin cancer treatment looking and feeling like yourself. This is especially true of large, advanced cancers, or lesions located in delicate areas, like the nose, lips, eyes, or cheeks. 

What are the different options for reconstruction after skin cancer?

Reconstruction can be performed directly after the removal of the cancer or at a later date. There are two main types of approaches for reconstructing the skin after cancer: conventional excision and Mohs. Grafting and local or free flap creation can also be used to improve your cosmetic results. Our team will work with your skin cancer professionals during the cancer removal process to ensure your reconstruction is seamless and stress-free. 

Basal cell carcinoma and squamous cell carcinoma. The two most common forms of skin cancer are treated in similar ways. Both require surgical excision or Mohs surgery to clear the disease. Mohs surgery involves excising the tumor layer by layer until it’s completely cleared, with the goal of removing as little tissue as possible to obtain clean margins. Once the cancer is gone, our facial plastic surgeons will close and reconstruct the wound to help the resulting defect blend in with the surrounding skin.  

Melanoma. Melanoma is a more aggressive cancer, so it requires a more extensive treatment when compared to basal cells or squamous cells. Mohs surgery is not advised for melanoma. Rather, surgical excision with wide margins is necessary. This makes it even more critical to work with a facial plastic surgeon who can close a large wound with care, reconstruct the area, and restore your pre-cancer appearance. 

What is Mohs surgery?

Dr. Frederic Mohs created this skin cancer removal method in 1953, and it has quickly become the go-to approach for removing cancerous lesions, especially from the delicate areas of the face. Performed in several stages, Mohs surgery takes out the guesswork when it comes to completely removing cancer from an area of the skin. 

With each layer of excision, a lab sample is examined. If cancer cells are found, the process is repeated. It continues until there are no more cancer cells found. By progressing slowly and methodically, this approach preserves the most amount of healthy skin cells. Mohs is said to have a cure rate of close to 99%.

What are the benefits of reconstruction after skin cancer?

  • Improved quality of life
  • Increased self-confidence
  • Preservation of healthy skin cells
  • Reduced discomfort after skin cancer removal
  • The body’s own tissue and skin can be used during the reconstruction process

What to expect

The steps involved in your unique reconstruction procedure will depend on the severity of your cancer and the size of the defect left behind after surgery.

  • Linear closure. A linear closure is possible for relatively small defects that are surrounded by healthy tissue. This approach involves placing an incision within a natural crease, closing it with care, and minimizing tension on the wound to reduce scarring. 
  • Local flap. If your wound does not qualify for a linear closure, a local flap will be used. In this case, your facial plastic surgeon will use nearby tissue to close the defect. 
  • Skin graft. If a local flap will distort your anatomy or result in excess tension on the wound, we may recommend a skin graft. This approach involves taking skin from another area of the body and transposing it to the site of your defect. As the graft heals, it will blend in with the surrounding tissue. 

For patients with larger defects, a multi-staged reconstruction may be necessary. In these cases, your surgeon may first reconstruct the area using cartilage or bone. Then, during a second procedure several weeks later, they will further refine the results with a flap or graft. 

Depending on the extent of your surgery, skin cancer reconstruction can take between thirty minutes and two hours to complete. Most patients can undergo the procedure with local anesthesia, and you will be able to return home the same day.

Austin Face & Body

Who is a good candidate?

If you have undergone a removal process for basal cell carcinoma, squamous cell carcinoma, or melanoma, you may be a suitable candidate for skin cancer reconstruction with a caring, experienced member of our team. Those who have undergone Mohs surgery for lesions on the face are eligible for reconstruction within a few days of their procedure.

It’s important that clients undergoing reconstruction are non-smokers. Smoking can negatively impact your results and lead to complications. If you do smoke, you will need to quit at least 6 weeks before and after your surgery.

What can I expect from recovery?

Recovery will be different for each patient, according to various factors, including their overall health, age, the extent of the changes needed, and whether the reconstruction was performed immediately or down the line. 

Our team will provide you with a detailed aftercare plan that goes over bathing and showering, sleeping, managing discomfort, returning to work, and resuming exercise. Scarring after skin cancer reconstruction can be improved through fat grafting and/or treatments with laser resurfacing, dermal fillers, and medical-grade scar creams.

Why choose Austin Face & Body?

Austin Face & Body was founded in order to provide Texas area clients with a cutting-edge, state-of-the-art facility where they could obtain access to the most advanced technology on the market. Our experienced, skilled plastic surgeons deliver nuanced transformations that preserve your natural beauty while minimizing cosmetic imperfections. Each of our practitioners is a leading authority in their field and is passionate about helping you to achieve your most cherished aesthetic goals.

Dr. Chris Schneider’s elite background in the complex, delicate art of microsurgery has earned him a reputation as amongst the most precision-oriented plastic surgeons in Austin and beyond. He performs a broad range of cosmetic and reconstructive techniques that help patients reclaim their appearance and quality of life. 

Dr. Schneider graduated from Texas A&M University College of Medicine before going on to complete a demanding general surgery residency at the University of Texas Health Science Center at Houston. He was then selected for an accelerated plastic surgery training program at the Louisiana State University Health Science Center in New Orleans, where he trained under Dr. Bob Allen, a pioneer in autologous flap surgery. 

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