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Dermatological Surgery
Surgery is the definitive treatment for the majority of skin cancers. While creams and lasers have their place for superficial sun spots, invasive cancers (like BCC, SCC, and Melanoma) must be physically removed to ensure the "roots" are gone. At Smooth Skin Clinic, our doctors are highly trained in skin cancer surgery, including complex closures like flaps and grafts. Our priority is a "cure first, cosmetic second" approach—we aim to completely remove the cancer while planning the incision to result in the finest possible scar.
Key Points
- Curative Surgery is the "Gold Standard" because it allows us to check the edges (margins) under a microscope.
- Local Anaesthetic All procedures are performed in our dedicated treatment rooms under local anaesthetic. You are awake, but the area is completely numb.
- Pathology Every piece of tissue removed is sent to a specialized laboratory to confirm the diagnosis and ensure the cancer is completely gone.
- Scarring Every cut leaves a scar. We use plastic surgery techniques to hide scars in natural wrinkle lines, but a mark will always remain.
- Downtime Depending on the location (e.g., leg vs. face), you may need to avoid exercise or heavy lifting for 1-2 weeks.
What is Skin Cancer Excision?
An excision involves cutting out the visible cancer along with a "safety margin" of healthy-looking skin around it. This safety margin is crucial because cancer cells often extend microscopically beyond what the naked eye can see. The wound is then closed with stitches (sutures).
Who needs surgery?
Surgery is required for:
Melanoma: To prevent it from spreading to the lymph nodes or blood.
Squamous Cell Carcinoma (SCC): Invasive growing lumps.
Basal Cell Carcinoma (BCC): Nodular or aggressive types that cannot be treated with creams.
Cysts and Lipomas: Benign lumps that are painful or unsightly.
Contact Smooth Skin Clinic to discuss your surgical options.
Clinical features
The clinical presentation involves two stages: the "Lesion" and the "Wound." The lesion itself—often a Squamous Cell Carcinoma (SCC)—typically presents as a tender, rapidly growing pink lump with a central crust or horn, or a non-healing ulcer with rolled edges. Following the surgical excision, the patient presents with a Suture Line. This appears as a linear incision, often 3 to 4 times longer than the original spot (an ellipse shape) to prevent "dog ears" (puckering) at the ends. The wound will be covered with stitches and initially appears red and raised before fading to a pale white line over 12 months.
The Surgical Proccess
Impact and complications
Scarring: Scars take 12 months to fully mature. They start red and lumpy but eventually turn white and flat. Infection: Rare, but possible. Signs include increasing pain, redness, and pus after 48 hours. Dehiscence: The wound opening up. This usually happens if the patient exercises or stretches the wound too early.
Frequently Asked Questions
Have questions about scheduling or what to expect? Here are answers to common inquiries to help you feel fully prepared.
Yes, for most body sites. However, if the surgery is on your eyelid or hand, or if you feel faint at the sight of blood, we recommend bringing a driver.
Once the numbness wears off (2-4 hours later), it will feel throbbing and sore. Panadol is usually sufficient. Avoid Aspirin as it thins the blood.
To remove a round circle of cancer and stitch it flat, we must cut an "ellipse" (football shape). If we just cut a circle and stitched it, the ends would bunch up into permanent lumps called "dog ears." The length is necessary for a flat scar.