Significant defects may result following skin cancer excision, including those excised by the dermatologist using Mohs micrographic surgery. Commonly called Mohs procedure, this procedure entails progressive removal and examination of single layers of skin until only cancer-free tissue remains. Following Mohs surgery, many patients require plastic surgical reconstruction of the nose, ear, and face. Reconstruction of these defects is dependent on the site and extent of the defect, but may include the use of flaps or skin grafts. Although any incision through the skin will result in a scar, plastic surgeons are specially trained in techniques to minimize the visibility of a scar.
Skin lesion excision is a procedure in which the plastic surgeon removes a cancerous skin lesion and an area of surrounding tissue called the margin.
There are three types of skin cancer: Basal cell cancer is the least invasive with the least amount of margin removed; squamous cell is more aggressive with a wider margin required. Melanoma is the most serious type of skin cancer, occurring in the cells that produce pigment.
Many types of benign skin growths may look like malignant tumors and are removed for a biopsy. If a lesion looks precancerous it may be removed as a precaution.
If the lesion is indeed cancer we will then excise the lesion with appropriate margins and then reconstruct the defect.
This procedure adjusts the shape of the eyelids and restores the bright and youthful eye appearance. It addresses saggy, droopy eyelids, or heavy bags beneath the eyes by removing the excess skin with an incision made in the eyelid fold. Excess fat that appears puffy under the eyes can also be removed with a hidden incision in the conjunctiva in well selected patients.
They are relatively simple procedures that are done in the office with local anesthesia. With aging the ear lobe may become loose and long. Reshaping or reduction of the ear lobe will restore its contour. Fat grafting can also be performed in order to restore its natural appearance and erase the lines.
Split earlobes can be the cause of chronic use of heavy earrings and tears. The borders of the tears are cut removing the healed skin on the inside of the long hole or the torn earlobe and the fresh edges are then sutured back together.
A thread lift is a procedure wherein temporary sutures are placed underneath the skin of the face, to produce a subtle but visible “lift” in the skin. Instead of removing the loose facial skin surgically, the skin is simply suspended. This procedure is temporary but can be used in selected patients that do not have much skin laxity and do not need a significant lift.