Skin Cancer Treatment – Melbourne

Types of skin cancers |  Risks  |  Recovery  |  Aim of skin cancer and melanoma management

We know that approximately two thirds of Australians will develop skin cancer or malignant melanoma during their lifetime. Even in the southern states, the UV damage to skin cells can result in malignant melanoma or non-melanoma cancers, such as basal or squamous cell cancers. Whilst certain skin types such as those with Celtic ancestry are more prone to develop skin cancers, all skin types can develop the condition.

NorthEast Plastic Surgery Melbourne treats melanoma and skin cancers

Having treated thousands of skin cancers and melanoma cases, the specialist plastic and reconstructive surgeons at NorthEast Plastic Surgery have the expertise to achieve optimal outcomes. They undertake reconstructions after melanoma and skin cancer resection which restore function and achieve optimal aesthetic results.

NorthEast Plastic Surgery Melbourne treats all types of skin cancers and melanoma

Skin cancers treated at NorthEast Plastic surgery include basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM).

Other skin cancers which are less common are also treated such as Atypical Fibrous Xanthoma (AFX), Malignant Fibrous Histiocytoma (MFH), Merkel Cell Carcinoma and Microcystic Adnexal Carcinoma (MAC).

NorthEast Plastic Surgery also undertakes removal of lumps such as lipomas and cysts in addition to excision of benign moles or naevi.

Basal cell carcinoma (BCC)

BCC is the most common type of skin cancer typically affecting the face, neck, scalp, legs and back.

BCC’s may invade deep structures locally but rarely spread to distal sites so early treatment results in better outcomes. Types of BCC include superficial, nodular, morphoeic and other less common varieties.

Whilst certain types of BCC’s can be treated without surgery, most are best treated with surgical excision and appropriate reconstruction.

Guidelines on BCC treatment comprise resection with 3mm to 5mm margins in conjunction with repair or reconstruction of the resulting defect.

Squamous cell carcinoma (SCC)

Typically more aggressive than BCC’s, SCC’s are the second most common skin cancer.

Whilst in situ or non-invasive SCC’s can be treated without surgery, invasive SCC’s require surgical excision as they can spread to other organs via lymph glands, nerves or the blood stream.

Guidelines on the management of SCC’s comprise surgical excision with 5mm to 10mm margins and appropriate reconstruction of the defect. In some cases radiotherapy may also be necessary.

Melanoma

Whilst MM can be cured if identified early, late presentation can impact longevity which makes melanoma the most serious type of skin cancer.

Most melanoma appears as a dark lesion but occasionally it can be non-pigmented. Changes of existing lesions may indicate development of melanoma.

Features which are useful guide to identifying melanoma include:

Asymmetry
Border notching
Colour change
Diameter greater than 6mm (the size of an eraser on the end of a pencil)
Elevation

The aim of malignant melanoma treatment is early detection and wide local excision surgery by 10mm to 20mm margins in conjunction with appropriate reconstruction. In situ melanoma is resected with a 5mm margin.

Risks of melanoma and skin cancer surgery and reconstruction

Incomplete resection margins which can impact cancer spread to local structures or distant organs is a significant risk to patients. The specialist plastic surgeons at NorthEast Plastic surgery focus on achieving clear excisional margins, whilst confident in their skills to reconstruct the associated defect once defined.

The risks of surgery will be discussed at your consultation with the specialist plastic surgeon. They include wound healing problems such as infection, bleeding, seroma formation, wound breakdown, graft or flap necrosis and scarring. Scarring is an individual phenomenon and may be wide, thick or discoloured. Skin cancer or melanoma surgery can also result in deformity resulting from removal of the cancerous tissue.

The surgeons manage these risks including by optimising patients before surgery. Strategies include cessation of smoking, management of blood thinning medication in consultation with your general practitioner or physician in addition to optimisation of diabetes mellitus or other medical conditions.

Which specialists should patients consult to remove and reconstruct melanoma and skin cancers?

Medical practitioners such as general practitioners, dermatologists, surgeons and plastic surgeons may undertake skin cancer and melanoma treatment.

The skill set of specialist plastic surgeons may be necessary to provide optimal outcomes where complex reconstructive techniques are required.

The specialist plastic surgeons at NorthEast Plastic Surgery work collaboratively with all medical practitioners to manage patients suffering from skin cancer needing resection and reconstruction and regularly undertake related educational events.

NorthEast Plastic Surgery’s aims of skin cancer and melanoma treatment

Complete cancer excision and reconstruction

The reason that the tissue removed and resulting scarring is larger than the cancerous lesion itself is that cancer removal requires an ‘excisional margin’ to achieve clearance of the tumour based on scientific guidelines.

The cancer removal surgery results in a tissue ‘defect’ which requires direct wound closure or reconstruction using advanced surgical techniques.

With over 20 years’ experience at skin cancer plastic surgery and reconstructive techniques including reconstructive microsurgery, the specialist plastic and reconstructive surgeons at NorthEast plastic surgery have significant experience in this area of practice.

The skin cancer surgeons have expertise in excision and reconstruction of skin cancers involving functional or aesthetically sensitive areas such as eyelids, nose, lip, ear or fingers. They are also experienced in treating cancers requiring more technically complex reconstructions due to aesthetic considerations such as the face, neck or chest or where wound healing can be challenging such as lower legs, feet and genitalia.

They have performed thousands of reconstructive operations ranging from skin cancer removal and direct wound closure to more complex reconstructive techniques including skin grafting, local flaps and microsurgical reconstructions.

Given their expertise, the surgeons are able to undertake the required resection margins with the technical ability and confidence to reconstruct the defect based on their reconstructive armamentarium.

Pathology

The skin cancer and melanoma resection specimens are examined by a specialist histopathologist to confirm adequacy of excision margins.

NorthEast Plastic Surgery aims to achieve the benchmark resection statistic of less than 3% incomplete or re-excision rates.

Skin cancer scar treatment

NorthEast Plastic Surgery has dedicated nursing and dermal therapy staff to minimise and treat skin cancer and melanoma scarring. The same techniques and protocols applicable to aesthetic plastic surgery patients of NorthEast Plastic Surgery such as our patients undergoing face and neck lift, breast or abdominal surgery is provided to our skin cancer and melanoma patients.

NorthEast Plastic Surgery Melbourne’s aesthetic and reconstructive patients achieve optimal functional and aesthetic outcomes due to this approach.

Skin cancer and melanoma surgery recovery – what can you expect?

Our bespoke aftercare is tailored to your individual needs, and you will receive personalised instructions from NorthEast Plastic Surgery based on your specific circumstances.

Generally, the dressings used by the specialist plastic surgeons at NorthEast Plastic Surgery are waterproof with the result that you can shower after surgery.

Recovery is usually complete over 2 to 3 weeks and during this time you may need to elevate the area, avoid certain activities such as swimming, driving or exercise depending on the operative site and will have antibiotic therapy prescribed.

Contact NorthEast Plastic Surgery for further information or to book an appointment to consult Dr Sugitha Seneviratne or Mr Patrick Tansley.

Second Opinion

Mr Patrick Tansley MD FRCS (Plast) and Dr Sugitha Seneviratne FRACS (Plast) provide second opinion consultations to patients seeking to address problems following skin cancer surgery performed elsewhere including revisional or corrective surgery. If you would like a second opinion on previously undertaken surgery, book a consultation to discuss this with one or both of our surgeons.