FAQs after Skin Lesion Excision
What is skin cancer?
There are a number of different types of skin cancers depending on the type of skin cell from which they arise. Each kind of skin cancer has its own distinctive appearance.
Basal cell carcinoma is the most common kind of skin cancer. They appear as pearl-like grayish nodules on the exposed areas. They grow slowly and rarely spread to other organs.
Squamous cell carcinoma appears as a scaly, reddish, dome-shaped, fleshy nodule, often with a central ulcer on sun exposed areas. They grow slowly, but can spread to other organs.
Malignant melanoma is the most serious kind of skin cancer. They appear as flat or raised growths of black or brown color anywhere on the body. Melanoma may show one or more of ABCDE characteristics:
Asymmetry: one part of the tumor differs from other parts
Border of the tumor is irregular
Color: tumor may be of different colors; often several colors are present in one tumor
Diameter above 6 mm (in most cases)
Evolving: lesion growths and changes color and appearance with time. They grow slowly or rapidly and may spread to other organs early via lymph nodes or blood, so it can be life dangerous.
How did I get skin cancer?
Skin cancer comes from years of sun exposure and sun damage.
How big is the cancer?
What is visible on the skin surface sometimes is only a small portion of the growth. Beneath the skin, the cancerous cells cover a much larger region and there are no defined borders. Your plastic surgeon may order a frozen section. In this procedure, the cancerous lesion is removed and microscopically examined by a pathologist prior to wound closure to ensure all cancerous cells have been removed. The goal is to look for a clear margin — an area where the skin cancer has not spread. If clear margins are found, the resulting wound would be reconstructed. If clear margins are not present, your plastic surgeon will remove more tissues until the entire region has a clear margin.
How long will the procedure take?
The procedure in total should not take more than 20-30 minutes.
Do I need to stop any medications?
We ask our patients to stop any medications that thin your blood such as aspirin/aspirin-containing products, fish oil, Motrin, vitamin E, and garlic pills. If you are prescribed Coumadin, Warfarin, Plavix, or another anticoagulant, please contact the prescribing physician and ask if it is OK to stop these medications 5 days prior to your scheduled procedure.
Is the procedure painful?
The surgical area will be injected with lidocaine, similar to dental Novocaine, which will numb the tissue. It is very rare that patients experience pain or discomfort after the lidocaine wears off. If so, over the counter pain medication will assist with any discomfort.
How many stitches will I have?
The excision site will be very conservative and large enough to remove the cancerous cells. The closure will also be conservative and as small as possible. Dissolvable sutures will be used to close tissue under the skin; nylon sutures will be used to close the top layer of skin.
How long will I have stitches?
Sutures in the face usually stay in for 5-7 days, the rest of the body 10-14 days.
Will I have a scar?
Unfortunately, there is no such thing as “scarless surgery.” Each time an incision is made, there will be a scar. However, your plastic surgeon will make every effort to treat your skin cancer without dramatically changing your appearance. Although every effort is made to restore your appearance as closely and naturally as possible, the most important factor is that your skin cancer is effectively cured.
How do I care for my surgical site?
We will apply a small piece of surgical paper tape to the excision site. If the tape falls off in the next week, you may apply a SMALL amount of antibiotic ointment and a band aid to the site. You may shower and get the area wet with the tape or band-aid on.
What are my activity restrictions?
Showers, washing, and hand washing the areas that have sutures are OK. We ask that patients do not take baths or participate in activities that totally submerge/soak the sutured area in water. If the excision site is in an area of tension such as the back, shoulders, chest, or joints; please refrain from exercising and strenuous movements of these areas.
Do I need someone to drive me?
No, this procedure is done under local anesthesia. You are able to drive yourself to and from the office. If for some reason the surgeon feels the procedure needs to be done under anesthesia, we will let you know in advance.
What are the risks for this procedure?
There is always a risk for infection, swelling, and bruising. Infections after this type of procedure is rare, and if do occur, can be treated with antibiotics. If there is swelling, ice can be applied for 20 minutes on and 20 minutes off to minimize. If bruising occurs, warm compresses can be applied.