Skin Cancer Excision
Excision of Skin Cancers & Reconstruction (Office-Based, Local Anaesthetic)
Measured removal of small facial skin cancers with discreet, unit-aware closures under local anaesthetic. Private hospital options are available for larger cases or for patients who have a strong preference to not be aware during their procedure.
My approach is considered, curated, and grounded in a deep understanding of facial anatomy. Oncologic safety comes first: appropriate margins, gentle tissue handling, and routine pathology. Reconstruction is planned to respect facial aesthetic subunits and relaxed skin-tension lines so scars are positioned thoughtfully.
Understanding Skin Cancer Excision
For most small facial skin cancers, treatment involves excision under local anaesthetic in the clinic, followed by primary closure, a local flap, or a skin graft – chosen according to size, depth, and location. All specimens are sent to pathology for confirmation and margin assessment. When lesions are larger or anxiety is significant, the procedure can be performed in a private hospital under sedation or general anaesthesia.
What is Excision & Reconstruction?
For most small facial skin cancers, treatment involves excision under local anaesthetic in the clinic, followed by primary closure, a local flap, or a skin graft – chosen according to size, depth, and location. All specimens are sent to pathology for confirmation and margin assessment. When lesions are larger or anxiety is significant, the procedure can be performed in a private hospital under sedation or general anaesthesia.
Reconstruction Options – Matched to the Defect
Primary (Direct) Closure
Best for:
Small, favourably-oriented defects with available skin laxity.
Approach:
Elliptical excision aligned with natural lines; layered closure to support edges and minimise distortion.
Local Flaps
Best for:
Areas where direct closure would distort nearby landmarks (e.g., eyelid, alar rim, lip, brow).
Types:
Advancement, rotation, transposition (e.g., bilobed, nasolabial, V-Y).
Aim:
Borrow skin from a nearby match to preserve contour and border definition.
Skin Grafts
Best for:
Defects where local tissue is insufficient or flap distortion risks are high.
Type:
Full-thickness skin grafts are preferred on the face for colour/texture match; secured with a gentle bolster.
Expectation:
Colour/texture blend improves over months; occasional refinements (dermabrasion/laser) may be considered once healed.
Who Is Suited to Office‑Based Treatment?
- Common small non‑melanoma skin cancers (e.g., basal cell carcinoma; selected squamous cell carcinoma in situ).
- Lesions in locations amenable to careful local anaesthetic work with measured downtime.
- Patients comfortable with in‑office procedures and aftercare instructions.
When hospital care may be better
- Larger or deeper lesions, or where complex flap staging is anticipated.
- Particularly anxious patients preferring sedation or general anaesthesia.
- Significant medical comorbidities requiring monitored care.
Recovery and Aftercare
Wound care
Follow dressing and cleaning instructions; avoid tension on the site.
Activity
Light activity from day 1; avoid strenuous exercise until advised.
Sun
Strict sun protection to support even pigmentation during healing.
Follow-up
Early review for wound check/suture removal; pathology results discussed; further visits as needed.
Risks of Excision & Reconstruction
All surgery carries risk. Possible complications include:
Bleeding, infection, haematoma, delayed healing or wound separation.
Scarring, widened/raised scars, or contour irregularity.
Partial flap/graft loss or colour/texture mismatch (generally uncommon in small defects).
Temporary numbness; rare motor nerve irritation depending on site.
Positive margins or recurrence requiring further treatment.
Anaesthetic considerations if hospital care is chosen.
Risks can be minimised through careful planning, patient selection, and adherence to postoperative instructions.
WHAT TO EXPECT
From Consultation to Recovery – Skin Cancer Excision
Why Choose Dr Karagiannis
for your Skin Cancer Excision?
1. Expertise & Experience
Multiple facial aesthetic fellowships across Europe and Australia with focused training in facial units, local flaps, and grafts.
2. Convenient Care
Office-based excision and reconstruction for suitable small facial cancers under local anaesthetic.
3. Scar Placement
Thoughtful scar placement along unit borders and relaxed skin-tension lines to protect form and function.
4. Anaesthetic Options
Option of private hospital care with sedation or general anaesthesia for larger cases or anxious patients.
Skin Cancer Excision FAQs
