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Skin Cancer

OVERVIEW

Skin cancers (Basal Cell Carcinoma, Squamous Cell Carcinoma and Melanoma) are the most common of all cancers. Accounting about 80% of all cancers diagnosis. This can have an impressive impact on patients' lives. Common aesthetic area of concern for patients undergoing skin cancer excision is the face.

Facial reconstructive surgery aims to restore the normal and symmetric appearance of the details of the face. Skin cancer treatments are life-saving, but they may leave scars or disfigure patients. Restoring facial harmony demands the unique skills of a plastic surgeon. Bringing together reconstructive and aesthetic aspects of plastic surgical techniques can minimize the impact of skin cancer treatment.

Types of Skin Cancer

  • Malignant melanomas account for approximately 5% of skin cancer diagnosis. These can be serious and very aggressive.

  • Squamous cell cancers (15% of skin cancers) can metastasize and spread to distant sites and therefore must also be considered more seriously.

  • Basal cell cancers (80% of skin cancers), typically do not spread to distant sites and tend to be slow growing. Basal cell carcinomas will extend into adjacent tissues (by direct invasion) and therefore CAN be very destructive. If ignored, they can lead to the loss of important tissues, and could conceivably eventually lead to death.

BENEFITS

Dr. Edgar Sosa trained at the prestigious Lahey Hospital and Medical Center, where his skills were perfected to address all types of skin cancer removal. Removal is best done with the complete excision of the lesion, including a small margin of the unaffected tissue, as this gives the greatest assurance that the lesion is removed in its entirety and will not recur.

In some cases (especially in recurrent cancers, cancers on the eyelid or nose edge margins, and in some other circumstances) a Dermatologist specially trained in the "Mohs" technique might be able to look at the tissue as it removed to determine the adequacy of removal. This provides not only the greatest possible assurance of complete removal but also that the least amount of normal tissue is disturbed.

In all cases of skin cancer, removed tissue MUST be sent for pathology.

Although treatment of one area may completely remove skin cancer, there is always a possibility that the inciting insult (i.e. sun exposure) to the skin would potentially affect other areas of the body. Recurrence is also a possibility with any treatment. Sun protection and early recognition of new lesions is essential. It is necessary for you to be followed closely by your Dermatologist and Primary Care Physician.

OPTIONS

After Dr. Edgar Sosa can determine the type of skin cancer and the treatment involves excision, the resulting defect would then require soft tissue repair. This could range from simply closing the defect with sutures, to mobilizing and rearranging surrounding tissues (a flap), or even employing a skin graft. Some degree of permanent scar will follow, but the important issue is how noticeable the scar will be.

Malignant melanomas require definitive excision, possibly with excision of the associated sentinel nodes. Prior to surgical excision, a Radiologist can inject a radioactive marker into the area of the tumor, which can be followed with a scan to identify which lymph nodes are associated with that area of the body. In the operating room, with the aid of a sterile Geiger counter, these lymph nodes can then be identified, removed, and sent for pathology to see if there is any evidence of metastatic disease. If the nodes are positive or there are other indications that the melanoma could spread, then chemotherapy would need to be considered and an Oncologist would need to be consulted.

Dr. Edgar Sosa conducts thorough consultations with all his patients for skin cancer surgery to address the full scope of what is to be expected before, during and post surgery.

Often, excision can be done in the office under local anesthesia, but sometimes excision needs to be done in the operating room under anesthesia. This is especially true in cases of larger lesions and those lesions which require more complicated reconstructions. If the surgical procedures requires general anesthesia, it can be accomplished in the outpatient department of the hospital or in a certified surgery center. All of Orlando Plastic Surgery Associates surgery cases that are performed in a ambulatory surgical facility are fully accredited to meet strict standards of the AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities).

RECOVERY

After recovery from surgery, you will be discharged home with care instructions. You will be sent home with pain medication, care instructions, and eye ointment to prevent eyes from drying too much.

After thigh lift procedure, it is recommended that patients wear their compression garments 24/7 for 4 weeks (except when showering or washing the garment) and then for an additional 3 weeks (only during the day or when active).

Bruising is noted after any surgical procedures. For blepharoplasty, patients may notice bruising along the area surrounding the eye. At about the third day after surgery, expect the area to be a deep purple, which will travel with gravity outside of the surgical area and be noticeable for 3-6 weeks. Many patients are able to return to work after a couple weeks and return to full activities after four to six weeks.

Dr. Edgar Sosa will continue postoperative care in the weeks following your surgery to ensure proper healing and satisfactory results.

For optimal results, always select a board-certified plastic surgeon. Surgeons who are certified by the American Board of Plastic Surgery have undergone extensive training in the field of both cosmetic and reconstructive plastic surgery.

Confidence is the most beautiful thing you can possess.

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