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 melanoma during their lifetime. Even in the southern states, the UV damage to skin cells can result in 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 but all skin types can develop melanoma or skin cancer.
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.
Skin cancers treated at NorthEast Plastic surgery include basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma.
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 Adenxal Carcinoma (MAC).
NorthEast Plastic Surgery also undertakes removal of lumps such as lipoma and cysts in addition to excision of benign moles or naevi.
BCC is the most common type of skin cancer affecting the face, neck, scalp, legs and back.
BCC’s may invade deep structures 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 BCC’s of certain types can be treated without surgery but most are best treated with surgical excision and appropriate reconstruction.
Guidelines on BCC treatment is resection with 3mm to 5 mm margins with repair or reconstruction of the resulting defect.
Typically more aggressive than BCC’s, SCC is the second commonest skin cancer.
Whilst in situ or non-invasive SCC’s can be treated without surgery but invasive SCC’s require surgical excision as they can spread to lymph glands, via nerves or the blood stream to other organs.
Guidelines on the management of SCC’s is surgical excision with 5mm to 10 mm margin and appropriate reconstruction of the defect. In some case radiotherapy may also be necessary.
Whilst it can be cured if identified early, late presentation can impact longevity which makes melanoma is the most serious skin cancer.
Most melanoma appears as a dark lesion but occasionally, can be non-pigmented. Changes of existing lesions may indicate the 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 melanoma treatment is early detection and wide local excision surgery of 10mm to 20 mm margin with appropriate reconstruction. In situ melanoma is resected with a 5 mm margin.
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 achieve clear excisional margins whilst confident in their skills to reconstruct the defect, once defined.
The surgery risks will be discussed at your consultation with the specialist plastic surgeon skin cancer and melanoma which include scarring. Wound healing risks which will be discussed include infection, bleeding, seroma formation, wound breakdown, graft or flap necrosis. Scarring is an individual phenomenon and may be wide, thick or discoloured. Skin cancer or melanoma surgery can result in deformity resulting from removal of tissue to treat the cancer.
The surgeons manage these risks by optimising patients before surgery and strategies include smoking cessation, blood thinning medication management in consultation with the general practitioner or physician in addition to optimisation of diabetes mellitus or other medical conditions.
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 regularly train medical practitioners on skin cancer removal and reconstructive techniques during educational events and work closely with all medical practitioners to collaboratively manage patients.
The reason that the tissue removed and the resulting scarring is larger than the cancerous lesion 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 closure of the wounds 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 the reconstructive armamentarium.
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.
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 face and neck lift, breast or abdominal surgery patients is provided skin cancer and melanoma patients.
NorthEast Plastic Surgery Melbourne’s aesthetic and reconstructive patients achieve optimal functional and aesthetic outcomes due to this approach.
As your aftercare is bespoke and specific to your circumstances, you will receive instructions from NorthEast Plastic Surgery which related to your needs.
Generally, the dressings used by the specialist plastic surgeons at NorthEast Plastic Surgery are waterproof so 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 with Dr Sugitha Seneviratne or Dr Patrick Tansley.
Mr Patrick Tansley MD FRCS (Plast) and Dr Sugitha Seneviratne FRACS (Plast) provide second opinion to patients seeking to address problems following plastic surgery performed elsewhere and 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.
As the privacy of our patients is of the utmost importance to us, we do not provide before and after photos on our website. You will be shown a number of before and after images during your private consultation to illustrate the potential outcomes of surgery. These images have been provided by previous patients who have consented to their private use.
E: melbourne@northeastplasticsurgery.com.au
T: (03) 9088 5000
F (03) 9088 5001
P 0411865055
(paging service for after hours emergencies only)
Essendon practice
53 Fletcher Street
Essendon
Vic 3040
Onsite parking and tram service (59) to the premises
St Vincents Private Hospital Consulting Suites
5 Studley Avenue,
Kew
Vic 3101
Onsite parking to the premises