Abdominoplasty
Breast augmentation
Breast reduction & uplift
Laser resurfacing
Fat Grafting
Liposuction
Melanoma
Sun protection
Basal cell cancer
Squamous cell skin cancers
Skin grafts
Facial repairs
Tissue expansion
Facial fractures
Trauma & burns
   
 
 
   
 
 
  Repair after facial skin cancer surgery  
 

When the amount of tissue (skin) that is required to be removed cannot be simply sutured(stitched) together, repair with skin imported from elsewhere on the patient is required. Flap repairs use immediately adjacent skin which is moved into the defect whilst maintaining a blood supply to that flap.

Alternately, skin grafts can be harvested from distant sites (eg around the ear or neck) and secured into the tumour excision defect. These grafts have to develop a new blood supply from the base and edges of the defect into which they are placed.
 

This patient had a recurrent Basal Cell Carcinoma just below the right nostril. It was excised and repaired with a flap from adjacent tissue beside the nose.

 
Result five days after surgery: The skin laxity in the donor area beside the nose is moved to the area of the skin defect resulting from the tumour excision.

Result after six months: The great advantage of using immediately adjacent tissue for the repair is that it provides the closest possible match for the texture and colour of the required skin.

This example of flap repair is described as a V to Y advancement flap.

 

 

This patient had an area of Basal Cell Carcinoma on the ear. Although the tumour was only small in size, there is not sufficient local tissue to allow the wound edges to be simply sutured (stitched) together.

An area of Basal Cell Carcinoma(left) and the defect(above) after excision
 

An island of skin with attached blood vessels is raised from a donor area behind the ear and transfered through a window in the cartilage.
   

The skin island has been sutured in place.

A flap of skin from the area of relative excess skin behind the ear was transfered to the front of the ear through a small window in the ear cartilage.

BCCs of the nose and flap repair

Clinical example 1:

Two Basal Cell Cancers on the nose. The tumours themselves are outlined in yelow, and the approximate planned excision margin in red.
   
The planned skin advancement repair flap for the lower tumour is indicated in purple. Early result four weeks post-operative. The upper nasal tumour was treated with a similar flap from the other side of the nose.
Clinical example 2:  
Nodular Basal Cell Carcinoma at nasal tip. Tumour edge dotted, excision margin marked with solid line. The skin V-Y advancement repair flap is outlined.
   
 
Flap is sutured (stitched) into position at end of operation  

BCC of the nose and graft repair
 
This patient had a recurrent Basal Cell carcinoma on the nostril margin.

The defect was repaired with a skin graft taken from an inconspicuous donor site in front of the ear where a close match of skin colour and texture was available.Result after 12 months.

 
 
Jonathan Stretch Plastic Surgeon D.Phil (Oxon) F.R.A.C.S.