Illinois/Chicago Area Plastic Surgery Procedures:
Excision of Skin Lesions

Dr. Paul M. Steinwald, has extensive experience in excision of skin lesions anywhere on the body, but especially in the facial area. (In fact, you can see a recent article on mole assessment and treatment that was formally reviewed by Dr. Steinwald at the cosmeticsurgery.com website.) These skin lesions may be:

Benign lesions, which include nevi (moles), cysts, lipomas (subcutaneous fatty tumors) or pre-malignant lesions such as actinic or seborrheic keratoses; or

Malignant lesions, including (most commonly) basal cell carcinoma (BCC), followed by squamous cell carcinoma (SCC), and malignant melanoma, which may require more aggressive, wider-margin excisions, and/or regional lymph node surgery by a surgical oncologist.

Basically, any non-healing (after 3-4 weeks) area of bleeding, excoriation (flaking) or ulceration, or any rapidly developing or darkening nevus/mole should be considered for excisional biopsy. For (non-pigmented) lesions that are suspected to be malignant, frozen section pathology can be arranged to obtain an answer as to the adequacy of margins during the case, which is usually performed under local anesthesia in the Lake Forest Hospital minor surgery suite. Plastic surgery closure techniques are used to obtain the best scar possible, which may include local tissue rotation techniques or skin grafts in the case of larger lesions.

Each of these patients had 1 cm or larger skin cancers or chronic wounds (we'll spare you the pre-op photos...), demonstrating a variety of plastic surgery closure techniques to obtain the best scars/minimal distortion possible: 1) Left upper lip melanoma-in-situ closed by advancement flap; 2) Right lower eyelid BCC closed by full-thickness (posterior ear) skin graft; 3) Mid-lower lip SCC wedge-excision, closed by advancement flap; 4) SCC of brow closed by glabellar/banner rotation flap; 5) Chronic wound of leg closed by split-thickness skin graft; 6) Melanoma of scalp closed by hair-bearing full-thickness skin graft; 7) Patchy melanoma-in-situ of left mid-cheek, closed with large rhomboid rotation flap from lower-lateral cheek; 8) BCC of mid-lateral nose closed by bi-lobed rotation flap; 9) Full-thickness SCC of mid-ear closed by "hinged" pull-through flap from behind the ear.

For more information on skin cancer and its treatment/prevention, please visit the American Society of Plastic Surgeons information page.

(Link references used with permission from ASPS.)