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Surgery for Skin Cancer

Surgery forms the mainstay of treatment for many skin cancers and moles. Cancers such as solid and invasive Basal Cell Cancers, Squamous cell cancers, and abnormal moles should be treated with surgery. Trusting a doctor with years of experience and training is important as this ensures that your skin cancer is completely removed, and your scarring is minimal. Looking after your wound after skin cancer surgery is essential for the best scar results.

Important facts on surgery for skin cancer

  • Skin cancer surgery forms the basis of treatment for invasive skin cancers including BCCs, SCCs, Melanoma, and Dysplastic Moles
  • Skin cancer surgery at My Skin Cancer Centre are performed in accredited theatres
  • Our Skin Cancer Doctors have further training in the management of skin cancers and provide patients with the highest quality of skin cancer surgery
  • Scars following surgery can be minimised with the use of special dressings and proper wound care

 

What types of skin cancers will need surgery?

Skin surgery is the Gold Standard of treatment for –

  • Dysplastic moles (abnormal moles)
  • Melanomas
  • Solid and invasive Basal Cell tumors
  • Squamous cell cancers
  • Keratoacanthomas

In this group of skin cancers, surgery provides the highest cure rate.

Read more about SCC

Read more about BCCs

Read more about Melanomas

How is surgery for skin cancer performed?

Surgery is performed in our operating theatres under very strict Queensland Health Guidelines. You will be given specific instructions prior to skin cancer surgery this includes-

  • Expected number of lesions to be removed
  • Expected number of stitches, and size of wound
  • Expected recovery time
  • Medications to stop or take prior to or after surgery
  • A quote for skin cancer surgery, and Medicare claim

 

The first step is the use of local anaesthetic to the area, prior to any surgery. All surgical cases at My Skin Clinics are conducted under ‘local’ and not ‘general’ anaesthetic. (I.e.you are fully awake for the procedure.) For patients who are anxious, we can provide mild sedation to make the procedure a more pleasant one!

Depending on the number of skin lesions removed, and the complexity of closure, you will be given an appropriate time slot ranging from 30 minutes to 90 minutes.

After surgery, dressings will be applied, and you will be given instructions on wound care. We will arrange a time for you to return for sutures or stitches to be removed.

All moles and lesions we remove are ‘tested under the microscope’ for final results.

Are there non-surgical methods to treat skin cancer?

pdt sun-spots cureYes, providing the skin cancer CAN be safely treated with other methods. Only some forms of superficial skin cancers can be safely treated by methods such as Photodynamic Therapy, Aldara, Double Freezing, or cautery.

Examples of skin cancers that can be treated with non- surgical methods include-

  • Thin or superficial BCCs
  • Thin or superficial SCCs – know as IECs or Bowen’s disease

Photodynamic Therapy is the most convenient method for treating thin cancers. This involves the use of a special cream concentrated in cancer cells. Following application of the cream, as laser- light source activates the chemical several hours later. Most skin cancers will require 2 treatments spaced a week or two apart.

Read more about Photodynamic Therapy for skin cancers

How will I know what treatment is best for me?

skin cancer surgeryOur skin cancer doctors will guide you as to the best treatment for your type of skin cancer. We will inform you of non-surgical treatments where suitable.

The primary aim of skin cancer work is to entirely remove skin cancer, whilst preserving as normal tissue.

 

How many stiches will I have?

skin graft specialistsThe number of stitches you will have depends on the location of the skin cancer and the size of the wound. More stitches are required if your wound is large, and if internal sutures are used.

Flaps and grafts will require more stitches compared to a normal or simple surgical wound. Your skin cancer specialist will tell you the number of sutures after surgery.

When will I need to remove stitches after skin cancer surgery?

Suture removal timings will depend on several factors including the location of the wound the complexity of wound closure.

As a guide-

  • Facial and scalp suture removal: 5-7 days
  • Trunk and limbs: 10-14 days
  • Flaps and grafts: 7-9 days

Suture removal and wound checks are conducted by our Specialist Nurses.

Do we use ‘self dissolving ‘ sutures?

Yes. In some situations we use special self-dissolving sutures- this provides maximal wound strength.

Self-dissolving sutures are used in wounds on the lower limbs and in some operations on the face and scalp.

We consider many other factors such as skin mobility, tension of the wound, wound size and contour, and location of the skin cancer as to whether or not dissolving sutures are used.

What will my scar look like after skin cancer removal?

skin cancer treatmentScars will be visible after skin cancer surgery; however with proper care and time, they will improve.

Following suture removal, scars are at their weakest, and extra care need to be taken not to over-exert the wound. Scars are often red and inflamed, however with proper taping, cleaning and time, will start to fade.

Complete scar remodelling does not occur for up to 6-12 months following skin surgery.

How can scarring be minimised after skin cancer surgery?

 

Looking after you wound is essential after surgery. Our skin cancer doctors will give you helpful instructions to minimise scars after surgery, including-

  • Limitations on activities
  • Taping the surgical wound
  • Use of silicone sheets or gel
  • Use of Bio Oil and massage
  • V Beam Vascular laser for redness

Proper wound care= Best scar results.

 

How can scarring be treated if it occurs?

skin cancer specialist surgeryScarring often fades with time, however if scarring is still significant after a few months, specialist laser dermatologists can fade the scar. Specialists use a variety of scar removal techniques including surgery, steroid injections, ablative and Fractional – Fraxel laser.

Read more about scar revision following surgery

What is Moh’s Micrographic Surgery?

Moh surgery brisbaneMoh’s surgery is a special form of skin cancer surgery, pioneered in the United States. This type of skin cancer surgery is performed in hospital, under the guidance of a team of Specialist including Dermatologists and Plastic Surgeons.

The vast majority of skin cancers will NOT require Moh’s surgery, however if you skin cancer exhibits very aggressive histology and margins involvement, your skin cancer doctor will work in with a Dermatologist- Plastic Surgeon for consideration of ‘margin control.’

This may involve Moh’s with a Dermatologist, or ‘Frozen section control’ under a plastic surgeon such as Dr Eddie Cheng, Dr Andrew Jenkins, Dr Phil Richardson, or Dr James Emmett.

Skin Cancer Doctor’s opinion on surgery and skin cancer

Dr Davin S. Lim

Laser Dermatologist

Westside Laser Dermatology

 

Skin cancer surgery forms the basis of our cancer cure at My Skin Cancer Centre.  Surgery is the only option, however in many cases maybe the very best option for a particular type of skin cancer. Skin cancers that are suited to surgery include solid and invasive BCCs, as well as SCCs, moles and melanomas.

Planning your excision with carefully placed incision lines, as well as correct surgical technique, and closures will provide optimal cure rates, whilst minimising scarring.

Most skin cancers require ‘simple surgery’, whilst larger or aggressive skin cancers in areas such as the nose, eyelids, and ears may require more complex closures such as flaps or skin grafts.