Skin cancers often involve the face or eyelids. The cancers typically appear as painless bumps or nodules and can be ulcerated with crusting and bleeding. The normal architecture of the skin or eyelid can distort, with loss of eyelashes or eyelash misdirection. A constellation of such findings warrants evaluation and may require a biopsy to confirm the diagnosis of skin cancer.
What are the causes of skin cancers?
Skin cancers are caused by excessive exposure to sunlight, especially in fair-skinned people who have a family history of skin cancers.
What are the most common types of skin cancer?
The most common types of skin cancers on the face and eyelids are basal cell carcinoma and squamous cell carcinoma. Both types of skin cancer enlarge locally and rarely spread (metastasize) to other parts of the body. However, with time, either type will invade adjacent tissue and structures.
Basal cell carcinomas are relatively slow growing. When detected early, there is a better chance of complete removal of the tumor, minimizing the amount of tissue to be excised.
Other more serious forms of skin cancers are melanomas. Melanomas can metastasize to other parts of the body. Melanomas require prompt, aggressive treatment because of the threat of early spread.
How is skin cancer treated?
Management of skin cancers of the face and eyelids focuses on two principles, compete removal of the tumor and reconstruction.
Complete removal of the skin cancer is crucial to minimize spread of the tumor and recurrence. There are two ways to have the skin cancer removed, either by frozen section control or Moh’s surgical excision.
Removal by frozen section refers to the oculofacial plastic surgeon removing the skin cancer and having a surgical pathologist examine the specimen for complete excision. Once the entire skin cancer is completely removed the reconstruction is performed to repair the surgical defect.
Moh’s surgery is performed by a dermatologist with further training in the skin cancer removal. The dermatologist excises the skin cancer and the specimen is evaluated by the Moh’s surgeon for complete excision. Once the dermatologist completely removes the tumor, the patient is then sent an oculofacial plastic surgeon for reconstruction, usually the next day. There are certain situations in which one technique for skin cancer removal is preferable to the other. Dr. Lissauer discusses during a consultation.
What should I expect after skin cancer reconstruction?
Reconstruction after skin cancer removal is varied and tailored to the location and size of the skin cancer removed. Regardless of the reconstructive technique chosen, the goal is to re-establish function to the area and provide an excellent cosmetic result. If the skin cancer involves the eyelid or other tissue around the eye, then the goals also include preservation of vision, and protection of the eye.
Any form of skin cancer removal on the face or eyelid can leave a scar. However, when the appropriate surgical reconstructive techniques are applied scarring may be minimized and an optimal cosmetic result obtained. After surgery, the complete healing process may take six months to a year. Once the reconstruction has healed, follow-up is necessary to insure the skin cancer does not recur. If a new skin cancer develops, it can be promptly diagnosed and treated.
If you would like to schedule a consultation please contact our New York office at: 212-717-2150 for an appointment.