Skin surgery - Facial reconstruction after cancer
The plastic surgeon is a major player in the treatment of skin cancer.
His knowledge of the anatomy and aesthetics of the face and body allows him to respond to the 2 imperatives of this surgery:
- remove the entire tumor
- to obtain a result that leaves as few aesthetic after-effects as possible.
The type of tumor will be defined by your dermatologist who will establish a diagnosis based on clinical examination and a biopsy.
There are several types of skin tumors:
- benign tumors which include, naevi (moles), histiocytofibromas, hamartomas...
- malignant tumors: basal cell carcinoma, squamous cell carcinoma, malignant melanoma.
Their surgical removal follows rules defined by the National Cancer Institute.
A multidisciplinary consultation meeting is mandatory before treating certain tumors (especially squamous cell carcinoma and malignant melanoma).
We work with the committee of the Henri Mondor hospital in Créteil and the one of the Clinique de la Muette in Paris.
In order to achieve a scar that is as discreet as possible, several surgical techniques are available to replace the area of skin that was removed with the tumor:
- Directed healing: this involves letting the body's natural healing processes take effect. This is an excellent method for small lesions on the nose and forehead
- direct suture respecting the natural lines of the face
- Skin grafting: skin is cut from an area with the same texture and color as the skin removed with the tumor, and then placed in a nurse on the former tumor site.
- a local flap: the skin adjacent to the removed area is moved towards it while respecting the aesthetic units of the face
- a regional flap: for example, part of the forehead is tilted towards the nose to reconstruct it
- a free flap: an area of skin (for example the forearm) is removed with its artery and vein and is reconnected under the microscope near the former tumor site. This technique is intended for very advanced tumors, especially those that invade the bone.
A pre-operative consultation with a dermatologist is almost systematic.
Your file is presented at a multidisciplinary consultation meeting if necessary.
The majority of procedures are performed in the operating room under local anesthesia combined with sedation (neurolepneumonia), during a short hospitalization of 3 to 5 hours (outpatient surgery).
However, in some cases, a short overnight hospital stay may be preferable.
The anesthesiologist will be seen in consultation at least 48 hours before the operation. It is strongly recommended that you stop smoking at least one month before and one month after the operation (smoking can cause a delay in healing).
No medication containing Aspirin should be taken during the 10 days preceding the operation.
Definitive healing is most often obtained between 10 and 15 days after the operation and allows the removal of the sutures.
The analysis of the surgical specimen will be checked by your surgeon who will refer you to your dermatologist to organize the follow-up and possibly post-operative treatments (radiation).
The final aesthetic result will only be judged at least 6 months after the operation.
Have a question? Please contact us!
Docteur Yaël Berdah and Docteur Marc-David Benjoar
Plastic surgeons in Paris France