Skin Cancer Removal & Reconstruction
Skin cancer is extremely common in Australia, particularly in coastal communities such as Newcastle. Early diagnosis and treatment are important, both to completely remove the cancer and to minimise the impact on surrounding healthy tissue.
Introduction
As a specialist plastic surgeon, my focus is not only on complete removal of the skin cancer, but also on preserving function and achieving the best possible reconstructive outcome. This is particularly important for skin cancers affecting the face and other cosmetically or functionally sensitive areas.
The most common skin cancers include basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma. I also diagnose and treat a range of less common skin cancers and skin tumours, working closely with your GP, dermatologist and other specialists where appropriate.
THE PROCEDURE
Treatment begins with careful assessment of the lesion and discussion of the most appropriate management. Wherever possible, skin cancers are removed with an appropriate margin of healthy tissue and the wound closed directly using meticulous layered closure techniques to support healing and produce the best possible scar.
When a direct closure is not appropriate, reconstruction may be required. Depending on the size and location of the defect, this may involve a local flap or a skin graft.
A local flap uses nearby skin to reconstruct the surgical defect while providing a good match in colour, texture and thickness. Although this technique often results in a longer scar, careful planning allows scars to be placed within natural skin creases or aesthetic boundaries wherever possible.
A skin graft involves transferring skin from another area of the body to reconstruct the wound. When carefully planned, with close attention to matching skin colour, texture and contour, skin grafts can achieve a very natural and often almost imperceptible result, particularly on the face.
Occasionally, more complex cancers or uncertain pathology require staged reconstruction, where the wound is temporarily managed until the final pathology confirms complete removal before reconstruction is undertaken.
THE PROCESS
Many patients are referred following assessment by their GP, skin cancer doctor or dermatologist and will already have had a biopsy confirming the diagnosis.
Where a diagnosis has not yet been confirmed, or there is uncertainty about the nature of a lesion, I may recommend performing a biopsy before proceeding with definitive treatment. This ensures the most appropriate treatment is planned, including whether surgery is required and the correct margins for excision.
Many smaller skin cancers can be treated comfortably in the clinic under local anaesthetic alone. Larger or more complex procedures may be performed in a private hospital under sedation or general anaesthetic.
All tissue removed is routinely sent for pathological examination to confirm the diagnosis and ensure the skin cancer has been completely excised. Following surgery, I provide ongoing review to monitor healing, discuss pathology results and guide scar management.
THE RECOVERY
Recovery depends on the size of the skin cancer, its location and the type of reconstruction performed.
Most patients are able to shower immediately after surgery. Wounds are usually covered with simple tape dressings or ointment rather than bulky dressings, allowing most normal daily activities to continue.
Swimming, prolonged water submersion and strenuous activity should be avoided until the wound has healed and sutures have been removed. For most patients, this is around one week for facial surgery and one to two weeks for surgery on other areas of the body.
Facial sutures are typically removed within the first week, while sutures on other parts of the body may remain in place a little longer.
Scars continue to mature over many months. Ongoing follow-up and scar management advice are provided to help achieve the best possible long-term result.
Treatment Risks
All skin cancer surgery carries potential risks, including:
- Bleeding and infection
- Delayed wound healing
- Visible scarring
- Numbness or altered sensation
- Recurrence or incomplete removal requiring further treatment
- Functional changes depending on the location of surgery, particularly around the eyelids, nose, lips or ears
These risks vary depending on the size, location and type of skin cancer and will be discussed during your consultation.
Pricing
The cost of skin cancer treatment varies considerably depending on the number of lesions, their size and location, the complexity of the reconstruction required, and whether treatment is performed in the clinic or in a private hospital.
Many smaller skin cancers can be treated under local anaesthetic alone, while larger or more complex procedures may require treatment in a private hospital under sedation or general anaesthetic.
As a general guide:
- Clinic procedures under local anaesthetic – from approximately $1,500 out of pocket
- Hospital-based procedures – from approximately $2,500 out of pocket
These figures are intended as a guide only. Where skin cancer surgery is medically indicated, Medicare and private health insurance generally contribute towards the cost of treatment. Following your consultation, you will receive a personalised written quotation outlining all anticipated costs before proceeding with surgery.
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