One in five Americans will develop skin cancer in their lifetime, and 40-50% of Americans who live to 65 years or older will experience basal cell or squamous cell carcinoma at least once. While these numbers may seem staggering, the numbers just don’t lie. That’s why it is so important to know how to prevent skin cancer, what to look for, and what is involved in treatment, including cancer removal and skin cancer reconstruction.
Prevention includes avoiding direct sunlight, wearing hats, wearing long sleeves and pants, wearing sunscreen with SPF (sun protection factor) 30 or greater, wearing sunglasses, and even applying SPF lip balm. More clothing is available, often listed as outdoors wear, that actually lists an SPF ratings on the tag. Moles that you should bring to the attention of your healthcare provider include those with irregular shapes or blurry borders, those with more than one color, those that are larger than a pencil eraser and any that have changed in size, shape or color.
Once skin cancer is identified, a surgeon who specializes in these types of procedures should remove it. The Mohs microscopic surgery method is the most commonly used and the most successful of all treatments of basal cell and squamous cell skin cancers. It has a 99% cure rate for new skin cancers and 95% cure rate for cancers that have recurred. The procedure involves injecting a local anesthetic, or numbing agent, and then removing the raised area of the tumor. Next, a thin layer of tissue is removed and closely examined for cancer cells. If any cancer cells are found, additional layers are removed until no more cancer cells can be visualized under the microscope. The procedure makes sure that all cancer is removed while disturbing very little healthy tissue.
Reconstruction following the Mohs procedure will depend on the size, depth and location of the tumor, as well as the patient’s overall health and cosmetic considerations. Small, simple wounds will be allowed to heal on their own. This type of healing, which is called second intention, is also a good option for cancer with a high risk of recurring, so that the area can be monitored more closely. Larger wounds may require simple stitches. Some more involved wounds may require skin flaps (where healthy tissue from an adjacent area of the body is repositioned over the wound and stitched) or grafts (where tissue may be removed from another area of the body and secured over the wound). For complex cases, or those involving structures such as the eye or nose, it may be necessary for more than one physician to participate in reconstruction.
After reconstruction, your healthcare provider will give you individualized instructions for care and recovery. This will include cleaning and bandaging the surgical site, prescriptions or over-the-counter medications, activity restrictions, follow-up appointments, stitches removal, and scar treatment. Some general recommendations include having someone drive you home, rest and eat a healthy diet, avoid aspirin until it is approved by your surgeon, and do not smoke. You should start walking as soon as possible after surgery, but you will tire more easily than usual. Your surgeon will detail your allowed activities, but anyone who has had facial surgery should avoid bending forward and should sleep or rest with their head up at a 45-degree angle by using couch pillows or a recliner. Do not remove the first surgical bandage unless instructed to do so by your surgeon, and follow any wound care instructions you are given.
Exposure to sun should be avoided for the first year. There may be some mild temporary discomfort, redness, or bleeding immediately after the procedure, but complication rates are very low. Some complications that may occur include scar formation, excessive bleeding, infection, and poor wound healing. It is important to follow your doctor’s recommendations and keep your follow up appointments. In some instances, additional procedures such as injections, laser resurfacing, or graft touch-ups may be required to minimize scarring. It is also very essential to remember that 2 out of every 5 people who experience skin cancer once will develop another within 5 years. This means that continuing practices that lead to prevention and watching for signs of recurrence is of the highest importance after all skin cancer reconstruction surgery.
If you are interested in learning more about skin cancer reconstruction, call Atlantic Center of Aesthetic and Reconstructive Surgery today at (954) 983-1899, or request an appointment online. We see patients at any of our locations in Ft. Lauderdale, Hollywood, Weston, Boynton Beach, or Naples, and look forward to helping you!