Skin cancer is the most common form of cancer in the United States. Basal Cell Carcinoma (BCC) is the most common form of skin cancer in the United States. While it is rarely fatal, it can be disfiguring if left untreated and allowed to grow. Squamous cell carcinoma (SCC) is the second most common form of skin cancer in the United States and grows faster than BCC. Melanoma represents a smaller portion of skin cancer diagnosis but it is one of the most common cancers affecting young adults. Its ability to spread makes early diagnosis and treatment essential.
Skin cancers are typically treated by surgical excision, which can result in the loss of tissue that can be disfiguring and result in the loss of function. Reconstructive surgery after skin cancer removal can involve a number of options. Small wounds can either be allowed to heal in by themselves or closed with sutures, referred to as “primary closure.” Other times a skin graft may needed. For some patients, larger wound or defects may require a “skin flap” to ensure the best possible repair. Skin flap surgery typically involves borrowing adjacent skin to help close defects from skin cancer removal. These come in many forms and are often specific for skin cancer defects of the nose, cheeks, eyes, ears, scalp or forehead. Most skin cancer surgery reconstruction can be performed in a single procedure. Sometimes, however, multiple procedures must be planned in order to ensure optimal cosmetic and/or functional outcomes.
Dr. Brown understands your concerns that skin cancer treatment may result in scars or disfigurement. He will guide you through treatment and explain the resulting effect on your health and appearance. Dr. Brown surgically removes cancerous and other skin lesions using specialized techniques to preserve function and minimize scarring. Although no surgery is without scars, he will make every effort to treat your skin cancer without dramatically changing your appearance.
Scars are visible signs that remain after a wound from surgery or injury has healed. Scars mature over time after an initial injury or surgery and even a wound that heals well can result in a scar that affects your appearance. They are unavoidable results of injury or surgery, and their development can be unpredictable.
Unattractive or disfiguring scars can result from poor wound healing, inherent skin coloration or pigmentation and/or the orientation of scars in comparison to the natural lines and creases the face and body. Scars may be raised or recessed, different in color or texture from surrounding healthy tissue or particularly noticeable due to their size, shape or location. Keloids represent an extreme form of scarring, where the scar extends beyond the boundaries of the initial wound or surgical incision.
In specific cases, scars are surgically excised and repaired using a variety of techniques to address their size, shape and orientation. Scar revision surgery is meant to minimize the scar so that it is more consistent with your surrounding skin tone and texture. Dr. Brown uses meticulous techniques to close wounds from a variety of injuries or surgeries to ensure the best possible outcomes.
Many nonsurgical treatments are also available to treat existing scars. Topical ointments, ranging from simple petroleum based ointments to silicone gels and sheets are often employed as wounds or incisions mature to minimize scarring. For certain patients, steroid treatments are employed over time to help improve scar appearance. Laser treatments can be employed to address the size, shape, contour and color of scars. Microneedling can be used to break up the fibrous tissues of the scar while PRP spurs the growth of healthy tissue. Often, the above treatments are used in conjunction to complement each other and ensure the best possible outcome.
Breast reconstruction includes a variety of procedures performed to restore the form and shape of the breast following mastectomy or lumpectomy surgery. Factors such as individual anatomy, aesthetic goals and the need for any postsurgical chemotherapy or radiation will determine your options. Discussing your cancer surgery with a plastic surgeon before undergoing mastectomy is crucial, because the proposed cancer removal surgery may significantly affect the choices and the results of breast reconstruction.
Options for breast reconstruction involve using breast implants (saline or silicone), reconstructing the breast using your own skin, fat and muscle or a combination of these methods. Most breast reconstruction methods involve several steps. The majority of breast reconstruction procedures are done as outpatient surgery. However, some may require a hospital stay for the initial procedure, particularly if it is done in conjunction with the initial mastectomy. Implant or expander insertion may not require extra hospital time if it can be done at the time of the mastectomy. Dr. Brown will help you weigh the pros and cons and select the method to benefit you the most.
Although breast reconstruction can rebuild your breast, the results are highly variable.
A reconstructed breast will not have the same sensation and feel as the breast it replaces.
Visible incision lines will always be present on the breast, whether from reconstruction or mastectomy. Certain surgical techniques will leave incision lines at the donor site, commonly located in less exposed areas of the body. If only one breast is affected, it alone may be reconstructed. In addition, a breast lift, breast reduction or breast augmentation may be recommended for the opposite breast to improve symmetry of the size and position of both breasts.