Facial skin cancer surgery
Basal cell carcinoma and squamous cell carcinoma are the commonest skin cancers and often appear on the face. Surgical removal is the main treatment and cures most of them.
Who it may help
- A spot or patch that bleeds, crusts or does not heal
- A confirmed basal or squamous cell carcinoma on the face, scalp, ears or lips
- Recurrent skin cancer after previous treatment
Recovery
Facial stitches are usually removed after five to seven days. Scars continue to soften and fade for 12–18 months. You will be given advice on sun protection and checking your skin.
What is involved
The lesion is examined, often with a dermatoscope, and a biopsy may be taken. Most operations are under local anaesthetic as a day case. The cancer is removed with a margin of normal skin and sent to the laboratory. The wound is closed directly, or with a local flap of neighbouring skin or a skin graft, chosen to protect the function and appearance of the eyelids, nose and lips. Results are reviewed by the skin cancer multidisciplinary team.
Risks and side effects
All surgery carries some risk. The main ones for this treatment are listed below; your own risk depends on your health and the details of your operation.
- Bleeding, bruising or infection
- Scarring, which can sometimes thicken
- Further surgery if the laboratory finds cancer cells at the edge of the removed tissue
- Problems with a flap or graft healing
- Numbness around the scar
- The cancer returning, or a new one developing elsewhere
Alternatives
Depending on the type and site, alternatives include Mohs micrographic surgery by a dermatologist, radiotherapy, creams, freezing or photodynamic therapy for some superficial cancers, and in selected cases careful observation.
Guidance and standards
Care follows NICE guidance on skin tumours and British Association of Dermatologists guidelines. Will is a member of the skin cancer multidisciplinary team (MDT), where surgeons, dermatologists, pathologists and oncologists review each case together, and he runs joint skin clinics with dermatology.
Questions worth asking at your appointment
- Benefits – what will this treatment do for me?
- Risks – what could go wrong, and how likely is it for me?
- Alternatives – what other options are there?
- Nothing – what happens if I wait, or decide not to have treatment?
Based on the Choosing Wisely UK BRAN questions.