Most skin cancers can be removed with simple excisions under local anaesthesia.
We locate the edges of the skin cancer using a dermatoscope then mark the excision lines with a margin of normal skin in between.
The wounds are typically closed in 2 layers using deep dissolvable sutures and nylon sutures on the surface of the skin which are usually removed a week later.
These techniques are used to obtain tissue samples of the lesion enabling an accurate diagnosis which guides our treatment. Most commonly these are done by punch or shave technique. These procedures are done under local anaesthesia. Punch biopsies are usually closed with a single suture and shave biopsies heal on their own without any suturing required.
We also treat benign skin lesions such as cysts or fatty lumps known as lipomas. These lesions usually require surgical excision which is done under local anaesthesia.
There are a number of different types of skin cysts. They can look unsightly, become irritated by clothing or develop infections on a recurrent basis which are possible indications for excision.
Lipomas are very common and typically seen on the trunk or limbs. They do have potential to grow to a large size and are best removed when smaller.
This is a surgical technique used to ensure the skin cancer is completely excised before embarking on surgical repair of the defect.
It is used primarily on the face and for cancers in difficult anatomical areas that will require more complex reconstructive surgery.
Margin control surgery involves at least two appointments. At the first surgery, the lesion is excised but the wound left open with a dressing sutured in place to keep the wound bed healthy. We then wait for pathological analysis of the specimen to ensure the cancer has been completely removed. If not completely gone, a wider excision is performed. Once the pathologist can confirm complete removal the wound is closed with a skin flap or graft.
Margin control surgery is usually performed under local anaesthetic.
Mr Derek Goodisson offers specialist reconstructive skin surgery for difficult skin cancers that require extensive surgery, and the repair of large defects. Margin control techniques are utilised and surgery is often performed under general anaesthetic for the larger and more complex procedures.
The type of reconstructive technique required is individual to each person and will be agreed upon with you after a thorough consultation and assessment by Mr Goodisson. Occasionally more than one surgery will be needed to achieve the optimum outcome.
If you have a scar that has healed in an unsatisfactory manner, Mr Goodisson may be able to revise the scar to improve the area. This can be done through further surgery, steroid injections, dermabrasion (smoothing the scar tissue with a very fine burr) or simple measures such as massage, wearing steri-strips or ultrasound treatment with a physiotherapist.