Skin cancer surgery

Different skin cancers need different plans

Basal cell carcinoma (BCC) usually grows locally, but can damage nearby tissue. Squamous cell carcinoma (SCC) has a variable risk of recurrence and spread. Melanoma requires a separate plan based on features such as tumour thickness and stage.

Not all skin lesions are cancer, and not every skin cancer requires the same type of surgery. Some selected lesions can be managed with non-surgical treatments or referral to another specialist.

Assessment and diagnosis

Consultation considers the lesion, any biopsy result, previous treatment, medicines, immune suppression, general health and personal history of skin cancer. A biopsy may be needed before definitive planning. Bring pathology reports and relevant referral information if available.

The visible edge of a lesion does not always show its full extent. The diagnosis and risk features guide the margin of tissue removed and whether further assessment or multidisciplinary input is appropriate.

Excision and reconstruction

Surgical excision removes the lesion with a planned margin, with tissue sent for pathology. Some wounds can be closed directly; others need a skin graft or local flap, or staged reconstruction. The final defect may be larger than expected from the surface appearance.

For facial lesions, protecting eyelid, nose, lip and ear function is part of planning. Facial skin cancer reconstruction considers these structures as well as scars and appearance. Occasionally further excision is required if pathology shows incomplete clearance.

Anaesthesia, recovery and follow-up

Smaller procedures may be performed under local anaesthesia; more extensive operations may require sedation or general anaesthesia and hospital care. Arrangements depend on the lesion, reconstruction and your health.

Wound care, dressings, activity restrictions and time away from work vary by site and repair. Pathology results and follow-up are essential parts of treatment. Further surgery, specialist referral or additional treatment may be advised after the final results.

Continue skin surveillance and sun protection as recommended by your treating doctors. Removal of one cancer does not prevent another developing.

Scars, risks and limitations

All surgery leaves a scar. A graft or flap can differ in colour, thickness or texture from surrounding skin. Risks include bleeding, infection, delayed healing, wound separation, altered sensation, contour differences, graft or flap loss, functional changes, recurrence and further surgery.

Report increasing redness, pain, swelling, fever, bleeding that does not settle or concerning wound changes promptly. Your postoperative instructions will explain when and how to seek help.

Frequently asked questions

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