Skin cancer surgery is a common treatment used to remove certain skin cancers. It involves removing the lesion along with a small margin of surrounding tissue to reduce the chance of cancer cells being left behind. Understanding when surgery may be recommended, what the procedure involves, and what recovery may include can help patients feel more informed before treatment.
What Types of Skin Cancer May Require Surgery?
Basal cell carcinoma, squamous cell carcinoma, and melanoma are three common forms of skin cancer that may be treated with surgery. Basal cell carcinoma often grows slowly, while squamous cell carcinoma can behave more aggressively in some cases. Melanoma is a more serious type of skin cancer and needs prompt medical assessment and treatment.
Not all skin cancers require surgery. Some superficial lesions may be managed with non-surgical treatments such as medicated creams, photodynamic therapy, or radiation. Surgery is often recommended when a lesion is of a certain size, depth, or location, or when a tissue sample is needed for pathological analysis. The appropriate treatment is determined following a thorough clinical assessment.
What Does the Procedure Involve?
During the surgery, the affected area is removed together with a small border of surrounding tissue. This extra tissue is taken to reduce the risk of cancer cells remaining, and the amount removed depends on the type of skin cancer, its size, and its location.
After the lesion has been removed, the wound is then closed. How this is done depends on the area treated and the amount of tissue removed. In some cases, the skin edges can be brought together and closed with stitches. If the area is larger or in a part of the body where closure is more difficult, a skin graft or a flap may be used. A skin graft uses skin taken from another part of the body, while a flap uses nearby tissue to cover the wound.
What Is Mohs Surgery, and When Is It Used?
Mohs micrographic surgery is a specialised technique used for certain types of skin cancer, particularly in areas where preserving as much healthy tissue as possible is important, such as the face. The procedure involves removing the lesion one thin layer at a time, with each layer examined under a microscope before the next is removed. This continues until no cancer cells are detected at the margins.
Mohs surgery is not required for every skin cancer. It is generally considered for cancers located in cosmetically or functionally sensitive areas, those that have returned after previous treatment, or those with features suggesting a higher risk of incomplete removal with standard excision. Whether this technique is appropriate will depend on an individual assessment.
What Are the Risks Associated With the Procedure?
Like all surgical procedures, skin cancer surgery carries risks. These may include infection, bleeding, wound healing difficulties, scarring, and changes in sensation around the surgical site. Where a skin graft or flap is used, there are additional considerations related to the donor site and the success of the tissue transfer.
There is also the possibility that surgical margins may not be clear, meaning further surgery could be required. The risks relevant to each patient’s situation should be discussed in detail before proceeding, as these will vary depending on the type of skin cancer, its location, and the extent of the procedure required.
What Does Recovery Involve?
Recovery after surgery can vary widely from one patient to another. A small procedure may involve only a short period of reduced activity, while a larger procedure or one that needs a graft or flap can take longer to heal. In those cases, you may need to limit movement and follow specific instructions in the early stages of recovery.
You will be given wound care instructions to help lower the risk of infection and support healing. Follow-up appointments are also important because they allow the treated area to be checked and any concerns to be picked up early. Ongoing skin checks are often recommended after treatment, as patients who have had one skin cancer have a higher risk of developing another.
What Should Patients Do After the Procedure?
Looking after your skin remains important after the procedure. This includes using broad-spectrum sunscreen, wearing protective clothing, and spending less time in the sun during peak UV hours. Regular skin checks are also recommended so new or changing spots can be noticed and assessed early.
It is also important to keep an eye on the treated area during recovery. If you notice unusual redness, swelling, discharge, or any other change that concerns you, contact the clinic for advice. Identifying problems early can help treatment be provided sooner if needed.
Why Choose A/Prof Bish for Skin Cancer Surgery in Sydney and North Shore
A/Prof Bish Soliman is a FRACS-qualified Specialist Plastic Surgeon with specialist registration in plastic surgery, practising across Sydney and North Shore. Skin cancer surgery and reconstruction form a significant part of his surgical practice. He holds two consultant positions at major Sydney tertiary referral hospitals and brings experience in complex reconstructive techniques. A/Prof Bish is a member of the Australian Society of Plastic Surgeons (ASPS) and the Australian Society of Aesthetic Plastic Surgeons (ASAPS).
A/Prof Bish Soliman uses a careful assessment process and clear communication when discussing treatment options. He takes the time to discuss the nature of the diagnosis, the surgical options available, the risks involved, and what recovery looks like, so patients are well informed before making any decision about their care.
