Skin cancer is the number one most diagnosed cancer in the world. Fortunately, the majority are curable and treatable. However, depending on the size and length of time present, some of these cancers can be devastating, with melanoma being one of the more serious types. If caught early, the chances of cure and survivability are significantly increased. Since our face is almost always exposed to sunslight, many skin cancers are found in this area. However, skin cancer can still be found in any part of the body. Over time with aging and sun exposure, the skin becomes damaged and can cause the cells to transform into cancer cells. That is why it is always important to wear sunscreen. If you see a lesion or bump somewhere that is either new or growing, contact your doctor immediately for a consultation. The earlier these lesion are detected, the better off you will be. Some people delay, thinking it is nothing serious, but these are the same patients that end up having a worse prognosis.
There are usually two steps in skin cancer treatment: the excision and reconstruction of the resulting defect. In the first step, a diagnosis needs to be made by either a biopsy or an excision of the lesion. This is sent to pathology for a diagnosis to be made. The amount of extra surrounding tissue that will need to be removed depends on what kind of skin cancer is diagnosed. Sometimes the excised lesion still has cancer present at the edges and thus more excision is required. If the pathlogy shows a benign lesion, then that’s good news! If the wound is small, it can be closed by stretching the surrouding tissues together. If the wound is too large to close, then a “flap” will need to be created to close the defect, which involves manipulating and rotating the surrounding tissue to close the wound. This involves making extra incisions in order to release the surrounding tissues.
Dr. Tsai has the facilities to provide pathology reading on any specimen removed, so he is capable of performing both the excision and reconstructing the resulting defect. Some patients have had the lesion excised elsewhere, and present to the office for reconstruction. Either way, during your consultation, Dr. Tsai will present you with all the possible options in detail and work with you to individualize treatment according to your specific goals and expectations to provide you with the best possible result.
Excision of the skin cancer only takes a few minutes. Reconstructing the resulting defect depends on the size of the wound. If the wound is small and only requires direct closure, this can be performed in a few minutes. If a “flap” needs to be created, it will typically take 1-2 hours to complete. All the above procedures could potentially be performed awake with numbing medication or under general anesthesia (fully asleep) in the attached surgicenter depending on your preference. Patients return home the same day as the procedure so transportation will need to be arranged. Your first checkup will be the following day in clinic. Advice is given to sleep at an upright angle in bed for 24 hours to decrease swelling and bruising to the face. Ice packs are also recommended for the first 24 hours, on and off. There may be bruising to the areas treated, but this is normal and will resolve over the next several days. Patients usually return to normal daily activities within a few days. Pain is tolerated with prescribed oral pain medication. Exercise is resumed approximately 4 weeks after the procedure.