Dermatological surgery
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.
Principles
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, including naevi (moles), cysts, histiocytofibromas, hamartomas, etc.
- malignant tumors: basal cell carcinoma, squamous cell carcinoma, malignant melanoma.
Surgical removal of these tumors is governed by rules defined by the French National Cancer Institute.
A multidisciplinary consultation meeting is mandatory before treating certain tumors (notably squamous cell carcinoma and malignant melanoma).
We work in close collaboration with the committees at Hôpital Saint Louis and Hôpital Georges Pompidou in Paris.
In order to achieve the most discreet scar 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
a skin graft: a portion of skin is cut from an area with the same texture and color as the skin removed with the tumor, and then placed in a nursey 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 (e.g. the forearm) is harvested with its artery and vein, and reconnected under the microscope close to the former tumor site. This technique is designed for very advanced tumors, particularly those invading bone.
In Practice
An intraoperative consultation with a dermatologist is almost systematic.
If necessary, your case will be presented at a multidisciplinary consultation meeting.
Most operations are performed in the operating room under local anaesthetic combined with sedation (neurolepnalgesia), during a short hospital stay of 3 to 5 hours (ambulatory surgery).
However, in some cases, a short overnight hospital stay may be preferable.
The anaesthetist will be consulted at least 48 hours before the operation. It is strongly recommended to stop smoking at least one month before and one month after the operation (smoking can delay healing).
No medication containing Aspirin should be taken in the 10 days prior to surgery.
Healing is usually achieved between 10 and 15 days after the operation, allowing sutures to be removed.
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!
Cosmetic surgery in Paris
Docteur Yaël Berdah and Docteur Marc-David Benjoar
Plastic surgeons in Paris France