Rates of melanoma and non-melanoma skin cancers continue to increase.  Treatments vary based on the type of skin cancer and other factors.  Surgical excision is one of the most common treatments for skin cancer and patients are often referred to a plastic surgeon for removal.  Here are 5 FAQ about plastic surgery for skin cancer removal:

Does plastic surgery for skin cancer removal leave a scar?

Unfortunately even plastic surgery leaves scars.  The goal of plastic surgery for skin cancer removal is to achieve clear margins while minimizing scarring.  Clear margins are determined by microscopic assessment in the lab.  This phrase means that the skin cancer has been removed with a cuff of normal skin and soft tissue around the edges and base, which lowers the risk of recurrence. If skin cancer cells are abutting the edge, there is increased risk that the lesion may recur locally or spread to distant sites in certain cases.  If a positive margin is found, options will also vary based on the type of skin cancer, site, and other patient factors.  Re-excision may be recommended in some cases vs. topical treatment (e.g. prescription antineoplastic creams) vs. close surveillance to monitor for recurrence.  Although scarring will result, plastic surgery involves meticulous technique as well as orienting the scars in such a way to minimize the appearance when healed.  For example, scars are often placed parallel to nature wrinkle lines, which will often result in a less conspicuous scar once fully mature.

Are stitches used in plastic surgery for skin cancer dissolvable?

In most cases permanent stitches are used, which are removed at a set time point post-operatively.  They are generally removed 6-7 days post-operatively on the face and at 10-14 days following excisions on the body.  Resorbable stitches are less frequently used.  If they fall out prematurely, the wound may open and if too late, more prominent scarring may result.  Since patients are returning to review pathology results – which guide whether further treatment is needed – the stitches are removed during the same follow up visit.

Can I swim after plastic surgery for skin cancer removal?

Swimming should be avoided until two days following suture removal in most cases.  It takes this long for the wound and suture tracts to close over following surgery.  At 48 hours following suture removal, patients may resume swimming and bathing if stable wound closure has been achieved.

Is pain medication required following plastic surgery for skin cancer removal?

In most cases, prescription pain medication is not needed.  Dr. Power recommends Tylenol plain or extra-strength if any discomfort is experienced.  Depending on the body site, elevation may also reduce discomfort; for example, elevating the extremities when resting or sleeping with one’s head propped up on 2-3 pillows depending on the surgical site.  Cold compresses applied intermittently over the first 48 hours may also reduce discomfort and swelling.

Can I shower after plastic surgery for skin cancer?

Yes, you may resume showering the day following your minor surgery.  A detailed wound care instruction sheet will be provided.  Gently washing the surgical site in the shower with soap and running water is recommended to lower risk of infection.  Following your shower, gently pat the incision dry to avoid trauma to the sutures.  A light application of vaseline is then recommended to promote moist wound healing.  If the incision is on your face, you may leave it open as desired.  If on the body, a band-aid is also recommended to avoid irritation from overlying clothing.

Skin cancer excision is one of the most commonly performed plastic surgery procedures.  Referrals may be faxed from one’s family physician or dermatologist for skin cancer removal by Dr. Stephanie Power, plastic surgeon, at 199 Avenue Road in Toronto. Please contact our office if you have any questions.