Procedure Spotlight
- Plastic Surgeons are highly trained in treating skin cancers
- There are 3 main types of skin cancer – Basal Cell Carcinoma, Squamous Cell Carcinoma and Melanoma
- Australia has one of the highest rates of skin cancer in the world
- There is a wide range of surgical reconstructive options in treating skin cancers to minimise deformity and scars associated with removal of skin cancers
Unfortunately, Australia has one of the highest rates of skin cancer in the world. In fact, skin cancer is the most common form of cancer in Australia. This is related to sun intensity, the hole in the ozone layer, and UV rays in Australia.
The best treatment is prevention and sun protection. Most of the damage is done during the early ages but it is never too late to prevent further sun damage.
Plastic Surgeons are highly trained in treating skin cancers. Dr Safvat has a special interest with vast experience in treating skin cancers especially the more advanced ones that are too complex for local practitioners and skin cancer clinics to deal with. He performs skin cancer surgery and reconstruction in the Sutherland Shire, Southern Highlands and Inner West areas of Sydney.
Skin Cancer Can Be Simplified Into 3 Common Types
Basal cell carcinoma (BCC) is the commonest of the cancers. In Australia the lifetime chance of getting a BCC is 1 in 4. Fortunately, BCC does not spread to other organs and grows only locally. BCCs are more common on the face. Early BCC can be excised with simple surgery but more advanced BCCs may need a local flap or graft.
Squamous Cell Carcinoma (SCC) is in between a BCC and MM. It can spread throughout the body but only in the very advanced stages. Most SCCs grow locally, and can be treated with a simple skin cancer removal surgery like a BCC.
Melanoma or malignant melanoma (MM) is the most aggressive and unpredictable of the skin cancers. It can affect any age and can rapidly spread though the body, depending on its thickness and the local lymph glands. Management of MM requires at least two operations. In the first one the stage of the MM is established based0n the pathology. Then a plan can be drawn for the final treatment. The second operation removes any leftover MM as well as a wider margin to ensure there is no recurrence.
Technique
Most skin cancers are small in size and therefore the wound will be sutured back together after the skin cancer removal. There are a variety of suturing techniques used to assist healing and wound strength as well as to achieve the best aesthetic outcome.
If the cancer is too large, tissue may need to be moved around in order to reconstruct the defect left after the cancer is removed. In these cases, a flap or a graft is used. Dr Safvat is highly experienced at performing these “local flaps” and grafts, with the aim to get rid of the cancer completely as well as reconstruct the defect, leaving minimal cosmetic or functional deficit.
A local flap is when tissue from the same area is rearranged. This method gives the best cosmetic results and is often used for the face.
A graft is used when a lot of skin needs to be removed and are unable to be joined back up due to the size of the defect. A graft is a thin piece of skin that is taken from another part of the body to reconstruct the cancer defect.
Rarely, even more complex forms of reconstruction are required called “reconstructive microsurgery”.
Dr Safvat is often asked by his dermatology colleagues or GPS to reconstruct the defect after they have excised the cancer.
Dr. Safvat is an accomplished plastic surgeon who offers wide range of surgical reconstructive options in treating skin cancers to minimise deformity and scars associated with removal of skin cancers, especially on the face.
Procedure Snapshot
| Anaesthetic Type: | Local Anaesthetic +/- sedation & rarely general Anaesthetic |
| Length of Surgery: | 60-120 minutes in most cases |
| Stay in Hospital: | Day stay in most cases |
| Downtime: | Minimal dependent on the location of the skin cancer |
Recovery
go home the same day. For more complex cases such as a skin graft on the leg, a stay in hospital may be required. Most skin cancer removal surgeries are only mildly uncomfortable with pain that can be managed with over-the counter pain medications. For more complex surgeries and depending on the location of the skin cancer removal, the pain and discomfort can be increased, however, Dr Safvat/ his anaesthetist will prescribe pain medication to keep you comfortable. Bruising and swelling are to be expected and in most cases this is fairly minor and will settle over the following week. The incision site should heal within 7-14 days and the sutures are then removed.
In most cases there is little downtime involved, depending on the type of work that you do. Dr Safvat will go through the recovery expectations with you in detail during your consultation.
Preparation
Smoking has been shown to cause complications after skin cancer removal surgery, particularly if a flap or graft is involved. Dr Safvat prefers that you stop smoking 3 weeks prior to your surgery wherever possible. You may have to stop certain medications such as blood thinners or some herbal medicines. Dr Safvat will discuss this with you during consultation.
Scars
There is no way to prevent scars completely after surgery and everyone can scar differently. However, the techniques Dr Safvat uses to suture his wounds are designed to minimise scarring. What’s more, any scarring will fade over time, especially if they are cared for correctly.
Dr Safvat will provide you with his specific protocol for scar management that will help you protect and care for your incisions in a way that will minimise scarring. Patients who have followed Dr Safvat’s protocol for scar management diligently have been very pleased with their progress in reducing and fading of scars.
In some cases, LED Light Therapy (available in Miranda only) may assist with wound healing, scarring and recovery and may be an option for some patients.
Complications
While all care and diligence is taken by Dr Safvat to minimise or avoid complications, any surgical procedure can be associated with some general complications and/or specific complications related to the surgery you are having. Choosing a Specialist Plastic Surgeon such as Dr Safvat and having your procedure done in an accredited hospital minimises risks as does using an accredited Anaesthesist.
Some general surgical potential complications are:
• Infection that may require antibiotics.
• Allergic reaction to dressings and other items used during the procedure.
• The formation of blood collection (haematoma) which could require additional surgery.
• Scars heal differently in different people. Some people are genetically prone to develop keloid scars. Hypertrophic scars develop when there is a complication in the healing process. Whilst not ideal, there is no threat to your health if you develop these.
• Anyone can have a heart attack or stroke from a clot. This risk is slightly increased with anaesthetics.
Some potential complications related to Skin cancer removal surgery specifically are:
• Bleeding from the wound.
• Incomplete Excision requiring further surgery/ treatment
• Wound breakdown
• Loss of skin graft or flap
Cost
Skin cancer removal surgery has a Medicare item number and patients should get a rebate from Medicare and their health fund (where applicable). The hospital costs are usually covered by private health funds depending on the patient’s level and type of coverage. Alternatively, you can have the procedure done in a Private Hospital as a Self-Funded patient. Another option in some cases, will be to have the procedure done in our rooms (Miranda or Bowral). This is not possible for all surgeries and Dr Safvat will discuss this with you if it is an option.
Detailed information regarding costs will be provided to you after your initial consultation.
Frequently asked questions
How can I prevent Skin Cancer?
To reduce the risk of developing further skin cancers it is important to protect yourself from the sun and avoid UV rays. Wearing hats, long sleeved shirts and using a high-quality sunscreen with SPF50 is highly recommended.
Are there any alternatives to Skin Cancer Removal surgery?
There are some non-surgical options available for skin cancers, however these may not always be appropriate and should be discussed with your medical practitioner or Dr Safvat. Some options are:
- Cryotherapy
- Laser
- Creams such as Effudix or Aldarra
When will I get my pathology results?
Dr Safvat will discuss your pathology results in person with you at your post-operative appointment this is 1-2 weeks following the skin cancer surgery depending on the location of the skin cancer.
How do I know if I have a skin cancer?
It is important to identify and treat a skin cancer sooner rather than later, particularly in the case of melanoma.
It is important to have regular skin checks with your GP or Dermatologist.
It is also important to monitor your skin, particularly spots and moles in order to pick up any changes that could indicate a skin cancer. Some potential warning signs:
- any crusty, non-healing sores
- small lumps that are red, pale or pearly in colour
- new spots, freckles or any moles changing in colour, thickness or shape over a period of weeks to months.
If you experience any of the above, it is important to get them checked as soon as possible.
Before and Afters
You must be over 18 years to view Dr Safvat’s before and after image galleries
Dr Safvat is a fully qualified Specialist Plastic Surgeon. Every patient is unique and results may vary. Any surgical procedure carries risks which need to be discussed with your doctor to ensure you are fully informed and realistic outcomes have been explained. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
These photos are of actual patients of Dr Safvat. Each has given consent for the photos to be used by Dr Safvat only.
DR ANDRE SAFVAT (MED1155201)
Registered Medical Practitioner, Specialist Plastic Surgeon (specialist registration in Surgery – Plastic surgery).
Dr André Safvat – Specialist Plastic Surgeon
Renowned for his dedication to his patients,
his attention to detail and impeccable outcomes,
Dr Safvat’s unparalleled expertise is reflected in the quality,
professionalism and dedication of every member of our team.
