Once a skin cancer has been removed the area needs to be reconstructed. There are a variety of methods for repairing these defects. Having performed over 15,000 reconstructive surgeries Dr Massey can help guide you as to what form of reconstruction is best suited for you. See examples of various reconstructions performed by Dr Massey below.
SIMPLE LINEAR REPAIR:
This involves closing the defect as a thin straight line of sutures. The positioning of this line, undermining to release tissue from the wound and placement of internal as well as external sutures are all important factors in how it will heal and the final cosmetic result.
LOCAL FLAPS:
With local flaps, releasing cuts are made in the surrounding skin to allow the skin to be pulled over the wound, rather like closing a curtain. (As this uses local skin the flap will usually blend into the surrounding skin better than a graft will).
INTERPOLATION FLAPS:
Sometimes skin immediately adjacent to the wound can not be used, and a more distant flap is used. In the first phase, skin is recruited from a donor area and sutured into the defect while it is still attached to its original blood supply. This is a temporary phase lasting two or three weeks. After a few weeks enough new blood vessels have grown into the flap from the surrounding tissue that it no longer needs the connection to its original blood supply. So in the second phase of this surgery the bridge of skin connecting the flap to its site of origin is removed and the flap is now fully in place. While this is a complex and lengthy process to go through, for certain defects it will give the best cosmetic results.
SKIN GRAFT:
When flaps are not a good option grafts can often be used. Here skin a removed from a relatively hidden location, such as behind the ear, and sutured over the defect, (rather like a patch on hole in your pants!). Over the next few days new blood vessels grow into the graft and so keep it alive. The final cosmetic results can be excellent, but because the graft is from a more distant location and has no blood supply of its own, the results are a little less predictable.
The best method of reconstruction will depend upon several factors including;
Having performed over 15,000 reconstructive surgeries Dr Massey can help guide you as to what form of reconstruction is best suited for you.