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Treatment

The only way to definitely tell if you have a skin cancer or not is to take a sample of the skin and examine it under a microscope. This is called a biopsy. Usually you have a biopsy under a local anaesthetic. But this will depend on where the possible cancer is and how large it is. A biopsy should always be done when skin cancer is suspected.

When you go to have your biopsy you will have an injection of local anaesthetic into the area to be biopsied. The plastic surgeon will then cut out a sample of skin tissue and send it off to the laboratory for examination under a microscope. This examination will specify the type of the cancer and will check if the excision is complete, meaning no cancer cells are left behind.

For most basal cell and squamous cell skin cancers an excision biopsy may be the only treatment needed while sometimes for melanoma further treatment will be needed.
In small cancers a primary closure may be enough to close the defect while larger defects will need special plastic surgery techniques (like skin flaps and skin grafts) for an aesthetic closure.
  • Skin graft
A skin graft is a piece of skin taken from another part of your body. This is done during the operation to remove your cancer.  A thin sheet of skin is removed from the donor site and placed over the area that needs to be covered. The donor site is usually somewhere where it will not be too obvious.

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The area where the skin graft is put will be very delicate while it heals. It is very important that the graft is not damaged while it is healing. You must be very careful not to knock it. A disadvantage of skin grafting is that sometimes the skin looks different from the surrounding area. It may be a different colour and appear as a dent compared to the surrounding skin.
  • Skin Flap
A way of repairing a large wound is a skin flap. To do this, plastic surgeons use a flap of skin and the tissue underneath it (the subcutaneous tissue). The flap is taken from very close to your wound. It is cut away more deeply than for a skin graft, but is left partly connected to its original site. This means the skin flap is still connected up to your blood supply. The flap is then positioned over your wound and stitched in place. Then the area it has been removed from is stitched closed. The skin flap has its own blood supply, so is likely to heal well.
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Skin flaps are a very type of specialist surgery and are more complicated than doing a skin graft. The advantages are that this type of repair often looks better than a skin graft.  So it tends to be used where the appearance of the skin is most important, such as on your face. As this is complicated surgery, it is done only by a specially trained plastic surgeon.



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