Basal and squamous cell skin cancers are the most common types of skin carcinomas. They start in the top layer of skin (the epidermis) and are often related to sun exposure. Surgery is the most common treatment for skin cancer. The type of surgery you have depends on the size of the cancer and where it is on your body. Small skin cancers can usually be removed with a wide excision under local anaesthetic however if you have a larger skin cancer, this may require you to have a general anaesthetic where the area of removed cancer is reconstructed and replaced with a skin graft or a skin flap.
Skin cancers are usually removed with a wide excision, rather than a simple excision which would be typical for a mole, cyst, wart or skin tag removal. This means the skin cancer is cut out together with some of the healthy skin around it. The healthy skin is called a margin and the reason for taking a margin is to remove any cancer cells that have spread into the surrounding tissue.
Any lesion removed, whether it has been confirmed by a biopsy to be a skin cancer or it is a suspected skin cancer, will be sent away to the laboratory for histological analysis. This can sometimes take a few weeks to come back and the results will be relayed to you by Mr Sherif Wilson MB, ChB, MS, FRCS (Plastic Surgery). Depending on the result, there may or may not be any follow up treatment needed.
A skin graft is a layer of skin taken from another part of the body and placed over the area where the skin cancer was removed. The place where the skin is taken from is known as the donor site. The place where it is moved to is called the grafted area. The amount of skin that is taken depends on the size of the area to be covered.
The donor site
Skin is usually taken from the thigh, buttock or upper arm however it can also be taken from the neck, behind your ear or inner arm. The donor site will be dressed to prevent any infection. The donor site can often feel more uncomfortable than the grafted area, but things usually settle within 1-2 weeks.
The grafted area
The grafted area is usually secured with stitches. It will have a dressing over it, which will be left in place while the graft heals. The skin graft will connect with the blood supply in the area. This usually takes around a week. The area will look red and swollen to begin with, but eventually it will heal, and the redness will fade. The grafted area will be quite fragile, and it is important not to put pressure on it or rub or brush against it.
Both the grafted and donor areas will develop scars. These should gradually become less noticeable. There will also be some difference between how the grafted skin and the skin surrounding it looks however this will lessen over time.
A skin flap is a slightly thicker layer of skin, which is taken from an area very close to the wound where the cancer has been removed. Skin flap surgery is very specialised. The flap is cut away but left partly connected so it still has a blood supply. It is moved over the wound and stitched in place.
Assessment for this surgery
Before you go ahead, it’s important you understand your options, what procedure you will be having and how the procedure works. Recovery time from basal and squamous cell cancer surgery varies, depending on the size of the tumor, whether lymph nodes were removed, and whether you undergo reconstruction so it is important you understand the recovery period. Mr Wilson will be more than happy to meet with you as many times as you need to ensure you are comfortable and happy before the procedure takes place.
Going home after surgery
Depending if you have had your procedure in the minor operations room or main theatres will determine your follow up plan. You will be able to go home on the same day regardless of where you had the procedure. Mr Wilson will follow you up regularly to ensure all is healing well. If the lesion has been sent off for analysis the results usually take up to 4 weeks to be returned and these will be shared with you and your GP and any further treatment will be recommended.
How much does this surgery cost?
Depending on the type of procedure you require, the cost of this surgery can vary. Minor procedures start from £700.00. Following an initial consultation with Mr Wilson, a bespoke quote will be provided, specific to each patient.
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