Skin Cancer Excision & Reconstruction

Recognising Suspicious Lesions

The most common skin cancers are basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma. Warning signs include a new or changing mole (asymmetry, irregular border, colour variation, diameter over 6mm, evolution), a sore that does not heal, or a lesion that bleeds, crusts or grows. If you are concerned about a lesion, contact your GP — suspected skin cancer is assessed urgently under the NHS two-week-wait pathway. See our GP Referrals page for the referral route.

Diagnosis

Diagnosis is confirmed by excision biopsy with histopathology, or occasionally punch/incisional biopsy where the diagnosis is uncertain before planning definitive surgery. Dermoscopy is used to assess suspicious pigmented lesions at consultation.

Surgical Management

Wide local excision with margins appropriate to the tumour type and, for melanoma, Breslow thickness — following national (NICE) guidance. For melanoma, sentinel lymph node biopsy may be recommended depending on tumour characteristics, discussed individually at your consultation. Many lesions can be excised and closed directly; larger defects, or those in cosmetically or functionally sensitive areas (nose, eyelid, lip, ear), may require a local flap or skin graft to reconstruct. Reconstruction following Mohs micrographic surgery elsewhere is a particular area of focus — see Nasal Reconstruction for nasal defects specifically.

Multidisciplinary Care

Mr Naparus is a member of the Specialist Skin Cancer Multidisciplinary Team (MDT) at Chelsea & Westminster Hospital, where complex or high-risk cases are discussed with dermatology, oncology and pathology colleagues to agree the optimal treatment plan.

Aftercare & Surveillance

Histology confirms complete excision and informs any further treatment
Suture removal typically at 7–14 days depending on site
Follow-up surveillance is arranged according to the tumour type and individual risk factors
Sun protection advice to reduce further lesions

Risks

Incomplete Excision

Occasionally margins are involved on histology, requiring further excision.

Scarring

Scar extent depends on lesion size and reconstruction technique; discussed in detail beforehand.

Infection & Bleeding

As with any surgical excision; managed with standard wound care.

Recurrence

Risk varies by tumour type, size and site; surveillance follow-up is arranged accordingly.

Individual Conditions

For detailed, condition-specific information, see: