Head-Neck Cancer Reconstruction
Skin Cancer Reconstruction
In deciding how to treat a wound, a plastic surgeon must carefully assess its size, severity, and features: Is skin missing? Have nerves or muscles been damaged? Has skeletal support been affected?
A split-thickness skin graft, commonly used to treat burn wounds, uses only the layers of skin closest to the surface. When possible, your plastic surgeon will choose a less conspicuous donor site.
A full-thickness skin graft might be used to treat a burn wound that is deep and large, or to cover jointed areas where maximum skin elasticity and movement are needed.
Tissue expansion is ideal for scalp repair because the stretched skin on the scalp retains normal hair growth. Most other body tissue does not grow hair to the same degree.
Following tissue expansion, the repaired scalp restores a more natural appearance.
What is reconstructive surgery?
The goals of reconstructive surgery differ from those of cosmetic surgery. Reconstructive surgery is performed on abnormal structures of the body, caused by birth defects, developmental abnormalities, trauma or injury, infection, tumors, or disease. It is generally performed to improve function, but may also be done to approximate a normal appearance.
Who has Reconstructive Surgery?
There are two basic categories of patients: those who have congenital deformities, otherwise known as birth defects, and those with developmental deformities, acquired as a result of accident, infection, disease, or in some cases, aging.
Some common examples of congenital abnormalities are birthmarks; cleft-lip and palate deformities; hand deformities such as syndactyly (webbed fingers), or extra or absent fingers; and abnormal breast development.
Burn wounds, lacerations, growths, and aging problems are considered acquired deformities. In some cases, patients may find that a procedure commonly thought to be aesthetic in nature may be performed to achieve a reconstructive goal. For example, some older adults with redundant or drooping eyelid skin blocking their field of vision might have eyelid surgery. Or an adult whose face has an asymmetrical look because of paralysis might have a balancing facelift. Although appearance is enhanced, the main goal of the surgery is to restore function.
Head-Neck Cancer Reconstruction
A bone/soft tissue flap is used to reconstruct the nose following skin cancer excision.
The incision lines of the flap are hidden within the natural creases of the nose and face.
A word about reconstruction.
The different techniques used in treating skin cancers can be life saving, but they may leave a patient with less than pleasing cosmetic or functional results. Depending on the location and severity of the cancer, the consequences may range from a small but unsightly scar to permanent changes in facial structures such as your nose, ear, or lip.
In such cases, no matter who performs the initial treatment, the plastic surgeon can be an important part of the treatment team. Reconstructive techniques- ranging from a simple scar revision to a complex transfer of tissue flaps from elsewhere on the body-can often repair damaged tissue, rebuild body parts, and restore most patients to acceptable appearance and function.
Recognizing Skin Cancer
Basal and squamous cell carcinomas can vary widely in appearance. The cancer may begin as small, white or pink nodule or bumps; it can be smooth and shiny, waxy, or pitted on the surface. Or it might appear as a red spot that’s rough, dry, or scaly…a firm, red lump that may form a crust…a crusted group of nodules…a sore that bleeds or doesn’t heal after two to four weeks…or a white patch that looks like scar tissue.
Though success will largely depend on the extent of a patient’s injury, flap surgery and microsurgery have vastly improved a plastic surgeon’s ability to help a severely injured or disfigured patient. Using advanced techniques that often take many hours and may require the use of an operating microscope, plastic surgeons can now replant amputated fingers or transplant large sections of tissue, muscle or bone from one area of the body to another with the original blood supply in tact.
The scar crossing the natural line, or crease, between the nose and mouth is removed and repositioned using Z-plasty. The forehead scar, located in the natural lines, is excised with tapered ends. The skin is then loosened and brought together with stitches.
The repaired scars now lie partly within the natural skin crease, where they are less visible.
If you’re considering scar revision…
Scars -whether they’re caused by accidents or by surgery- are unpredictable. The way a scar develops depends as much on how your body heals as it does on the original injury or on the surgeon’s skills.
Many variables can affect the severity of scarring, including the size and depth of the wound, the blood supply to the area, the thickness and color of your skin, and the direction of the scar. How much the appearance of a scar bothers you is, of course, a personal matter.
While no scar can be removed completely, plastic surgeons can often improve the appearance of a scar, making it less obvious through the injection or application of certain steroid medications or through surgical procedures known as scar revisions.
If you’re considering scar revision, this will give you a basic understanding of the most common types of scars, the procedures used to treat them, and the results you can expect. It can’t answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask your doctor if there is anything about the procedure you don’t understand.
After Scar Revision
With any kind or scar revision, it’s very important to follow your surgeon’s instructions after surgery to make sure the wound heals properly. Although you may be up and about very quickly, your surgeon will advise you on gradually resuming your normal activities.
Skin Cancer Reconstruction
Basal cell carcinoma may come in many forms. It often begins as a small, pearly nodule.
Small skin cancers can often be excised quickly and easily in the physician’s office.
Simple excision usually leaves a thin barely visible scar.
Skin cancer is the most common form of cancer in the United States. More than 500,000 new cases are reported each year-and the incidence is rising faster than any other type of cancer. While skin cancers can be found on any part of the body, about 80 percent appear on the face, head, or neck, where they can be disfiguring as well as dangerous.
The primary cause of skin cancer is ultraviolet radiation -most often from the sun, but also from artificial sources like sunlamps and tanning booths. In fact, researchers believe that our quest for the perfect tan, an increase in outdoor activities, and perhaps the thinning of the earth’s protective ozone layer are behind the alarming rise we’re now seeing in skin cancers.
Anyone can get skin cancer-no matter what your skin type, race or age, no matter where you live or what you do. But your risk is greater if…
- Your skin is fair and freckles easily.
- You have light-colored hair and eyes.
- You have a large number of moles, or moles of unusual size or shape.
- You have a family history of skin cancer or a personal history of blistering sunburn.
- You spend a lot of time working or playing outdoors.
- You live closer to the equator, at a higher altitude, or in any place that gets intense, year-round sunshine.
- You received therapeutic radiation treatments for adolescent acne.
Skin cancer is diagnosed by removing all or part of the growth and examining its cells under a microscope. It can be treated by a number of methods, depending on the type of cancer, its stage of growth, and its location on your body. Most skin cancers are removed surgically, by a plastic surgeon or a dermatologist. If the cancer is small, the procedure can be done quickly and easily, in an outpatient facility or the physician’s office, using local anesthesia.
Port-Wine Stain Removal
Info coming soon! Read more…
Tattoos have become increasingly more common, and so has the decision to remove them! Many people feel the tattoo that they got in the past no longer fits their image. Fortunately, today’s advanced lasers are able to safely remove the tattoo with very little risk of scarring.
The lasers work by using specific wavelengths of light that are absorbed by the tattoo ink. The tattoo ink is then vaporized. The patient’s own body then cleans up the remaining fragments of the ink. The skin is left intact. Because your body is responsible for cleaning up the debris from the laser treatments. Each treatment has to be space several weeks apart. Most tattoos require multiple treatment sessions. The number of treatments required depends on the size, color, age location of the tattoo.
Professional tattoos tend to be darker and deeper than amateur works. Consequently, professional tattoos tend to require more treatments.
Diminishing unsightly ‘spider veins’
Millions of women are bothered by spider veins – those small yet unsightly clusters of red, blue or purple veins that most commonly appear on the thighs, calves and ankles. In fact, it’s estimated that at least half of the adult female population is plagued with this common cosmetic problem.
Today, many plastic surgeons are treating spider veins with sclerotherapy. In this rather simple procedure, veins are injected with a sclerosing solution, which causes them to collapse and fade from view. The procedure may also remedy the bothersome symptoms associated with spider veins, including aching, burning, swelling and night cramps.
What are Spider Veins?
Spider veins – known in the medical world as telangiectasias or sunburst varicosities – are small, thin veins that lie close to the surface of the skin. Although these super-fine veins are connected with the larger venous system, they are not an essential part of it.
A number of factors contribute to the development of spider veins, including heredity, pregnancy and other events that cause hormonal shifts, weight gain, occupations or activities that require prolonged sitting or standing, and the use of certain medications.