Skin Cancer Excision

IN SYDNEY

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.

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

1. 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.

2. 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.

3. 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.

OFFICE-BASED EXCISIONS

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.

HOSPITAL-BASED EXCISIONS

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.

WHAT TO EXPECT

From Consultation to Recovery - Skin Cancer Excision

Consultation

· Review of diagnosis/biopsy, dermoscopy as appropriate, and photographic documentation.
· Discussion of margins in line with current guidelines, closure options, expected scar placement, and aftercare.
Procedure Day (Clinic, Local Anaesthetic)

· Duration: Typically 30-60 minutes depending on size and reconstruction.
· Comfort: Local anaesthetic with gentle technique; you remain awake and comfortable.
· Technique: Precise excision; layered closure, flap, or graft as planned; specimen sent to pathology.
Early Recovery (Days 1-7)

·  Mild bruising/swelling; simple analgesia usually sufficient.
·  Keep dressings clean/dry; specific instructions for graft bolsters if used.
·  Suture removal (typical guide): face 5-7 days; scalp 7-10 days.
Weeks 2-8 and Beyond

· Begin silicone therapy and scar massage once closed and reviewed.
· Pinkness and firmness gradually settle; sun protection helps limit pigment change.
· If margins return involved or close, we’ll discuss re‑excision or further management.

RECOVERY

Your Recovery & 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.

SURGICAL RISKS

Risks of Excision & Reconstruction

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.

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.