Skin Cancer Removal and Reconstruction

There are many types of skin cancer. Melanoma type skin cancer forms in melanocytes (pigment skin cells). Basal cell skin cancer forms in the small round cells in the outer layer of the skin. Squamous cell skin cancer forms in the flat cells in the outer layer of the skin. Rarer types of skin cancer can form in the neuroendocrine cells of the skin. Most skin cancer forms in older individuals in sun exposed areas or in patients with weakened immune systems. According to the National Cancer Institute, there were over 1 million new non melanoma skin cancers diagnosed in the US in 2009. Treatment of your skin cancer often requires surgery to remove the cancer, together with a rim of unaffected skin (the margins) to reduce the chance that the skin cancer will come back. Depending on the type, location and appearance of your cancer, Dr. Lu may recommend wide local excision (for small, well localized lesions), wide excision with frozen section controls (where a pathologist looks at the tissue removed immediately to determine whether additional tissue needs to be removed), or Moh’s excision in conjunction with a Moh’s dermatologic surgeon. If you are recommended to have Moh’s surgery, you will have your cancer removed on one day, and your wound reconstructed the following day. A small wound may be directly closed into a straight line scar. A larger wound may require repositioning of adjacent tissue to cover the wound (flap closure) or alternatively, a skin graft. Scars will be positioned to best follow natural skin lines and to minimize distortion of normal facial features and to restore a more natural appearance, however, no reconstruction is perfect and scars, tightness and distortion may persist. More than one surgery may be necessary to obtain clear margins or to perform an optimal reconstruction. The most important goal is to cure the skin cancer.