• 425.316.5080

    12800 Bothell-Everett Hwy, Suite 260
    Everett, Washington 98208

Samuel Lien, M.D.
Jeffrey Scott, M.D.
James Edwards, M.D.
Prabhat Bhama, M.D.

Skin Cancer Before & After Photos

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Skin Cancer Patient 1


This patient was referred to Dr. Bhama by a Mohs surgeon for reconstruction of a nasal defect following Mohs surgery for basal cell carcinoma. On pre-op view notice the defect of the nasal tip. Options were discussed with the patient and she elected for paramedian forehead flap reconstruction. Surgery went well, and shown is an early post-operative photo. The scar will continue to improve with time. She was very happy with the cosmetic result and has no difficulty breathing through her nose.


Skin Cancer Patient 2


This patient was referred by a Mohs surgeon to Dr. Bhama for management of an aggressive squamous cell carcinoma (skin cancer) of the right brow and forehead that appeared to be adherent to the underlying deep tissues and possibly bone. Because the tumor was aggressive, surgery was performed in an expeditious manner. Pre-operatively, notice the large scab overlying the brow. There was a extension of the tumor deep to the skin in all directions for several centimeters, and the tumor invaded the muscles of the forehead. Dr. Bhama excised the tumor under local anesthetic in our Mill Creek procedure room. The tumor invaded the frontalis muscle which had to be removed. After removal of the tumor, there was a large defect of the forehead and brow, extending into the upper eyelid. Dr. Bhama performed reconstruction under general anesthesia using an A to T flap technique, recruiting tissue from both the forehead and temple. A 1 month post-operative result is shown demonstrating excellent healing and a good cosmetic result considering the entire lateral brow had to be removed. No revision surgery, injections, or dermabrasion have been performed. The scar will continue to fade, and the notching will be repaired under local anesthetic.


Skin Cancer Patient 3


This patient underwent Mohs surgery for excision of a basal cell carcinoma from the nose and was referred to Dr. Bhama for repair of the resulting defect. Note the defect of the left nasal ala. Because of the importance of this structure in breathing, the patient had to undergo not only reconstruction of the skin defect, but repair of the nasal valve to facilitate breathing. She underwent complex staged reconstruction using an interpolated melolabial flap with auricular (ear) cartilage grafting. Her intermediate photo is also shown, demonstrating the pedicled flap. Also shown in an early post-operative view demonstrating excellent contour of the nose. No revision surgery has been performed, and no steroid injections have been performed.


Skin Cancer Patient 4


Dr. Bhama was asked to perform reconstruction on this patient who underwent Mohs surgery for treatment of skin cancer. Pre-operative photographs show a substantial defect of the right nasal ala and sidewall extending nearly down to the mucosa. Options were discussed with the patient including melolabial interpolated flap, paramedian forehead flap, and delayed reconstruction technique. The patient elected for delayed reconstruction technique using a full thickness skin graft from the pre-auricular region (in front of ear) on the right side. Early post-operative photos show an excellent cosmetic result. No revision surgery has been performed, and no steroid injections have been performed. The patient’s ability to breathe through the nose on that side has also been preserved. The appearance of the donor site in the cheek in front of the right ear will continue to improve with time.


Skin Cancer Patient 5


This patient underwent Mohs surgery for excision of a lentigo maligna from the nose and was referred to Dr. Bhama for repair of the defect. Note the defect of the nasal tip and dorsum. Options were discussed with the patient, and she elected for bilobe flap repair of the nose. Surgery went well, and shown is a very early post-operative result. No revision surgery, dermabrasion, or steroid injection were performed as the patient was very happy with the results. The scar will continue to heal, improving the result with time.


Skin Cancer Patient 6


This patient was referred to Dr. Bhama by a Mohs surgeon to discuss reconstructive options following nasal surgery for skin cancer. Pre-op views demonstrate a defect of the right nasal ala. Dr. Bhama discussed options with the patient, and the patient elected for paramedian forehead flap reconstruction. Dr. Bhama also used auricular cartilage to stabilize the nasal valve and preserve the patient’s ability to breathe through the right nostril. Intermediate photos demonstrating the forehead flap in place are shown. Early post-op photos are shown demonstrating an excellent cosmetic result. The patient is very happy and is able to breathe well through the nose.


Skin Cancer Patient 7


This patient was referred to Dr. Bhama to plan reconstruction after removal of a large melanoma from the right cheek. On pre-op photos, notice the pigmented lesion of the right cheek. The surgical oncologist performed excision along with sentinel lymph node biopsy. Notice the large defect of the right cheek and eyelid, and the incision in the neck. Normally, Dr. Bhama considers cervicofacial advancement flap (face and neck flap) to reconstruct these defects, but the neck incision for the sentinel lymph node biopsy could interrupt the blood supply to this flap. This is a very complex defect to repair given the close proximity to the eyelid, therefore a rhombic transposition flap was designed such that the vectors of tension would pull the lower eyelid upwards instead of down. Early post-op pics are shown. The patient was very happy with the cosmetic result. Notice that there is no distortion of the eyelid. No revision surgery or dermabrasion has been performed. The scar will continue to fade with time.


Skin Cancer Patient 8


This patient was referred to Dr. Bhama by a Mohs surgeon to plan reconstruction following Mohs surgery for a melanoma in situ of the left cheek. Pre-operative pictures are shown demonstrating a pigmented lesion of the left cheek. The patient underwent Mohs surgery with another surgeon. Shown is the defect. There is a large skin defect of the left cheek involving skin and soft tissue. This defect presented a unique challenge because of its close proximity to the frontal branch of the facial nerve and the eye. Dr. Bhama performed rhombic flap reconstruction under local anesthesia with the patient completely awake. She was able to go home immediately after reconstruction. Her post-op photos with sutures in place are shown. Early post-op photos after suture removal are also shown demonstrating an excellent cosmetic result. Notice there is no distortion of the eyelid. The facial nerve is completely intact. The patient was very happy with results, and her scar will continue to fade with time.


Skin Cancer Patient 9


This patient was referred to Dr. Bhama by a Mohs surgeon for reconstruction of a large facial defect following Mohs surgery for melanoma in situ. On pre-op photos notice the large defect of the medial cheek and eyelid. This defect presents a significant reconstructive challenge since it is in such close proximity to the eyelid, putting the eyelid at risk for distortion. Dr. Bhama and the patient discussed several reconstructive options and the patient elected for cervicofacial advancement flap. A lateral canthoplasty was also performed to suspend the eyelid. Surgery went well and the patient was very happy with results. Very early post-operative photos are shown, demonstrating complete take of the flap, and no distortion of the eyelid. The patient had completely intact facial nerve function. The scar will continue to fade with time.


Skin Cancer Patient 10


This patient was referred to Dr. Bhama by a Mohs surgeon for reconstruction following Mohs surgery for skin cancer of the right medial canthus region. Pre-operative photos demonstrate a defect of the right nasal sidewall and medial canthus region. Options were discussed with the patient and he elected for local flap reconstruction. Dr. Bhama performed glabellar flap reconstruction under local anesthesia in our Mill Creek procedure room. Early post-operative photos are shown demonstrating an excellent aesthetic result. No revision surgery was performed. The patient was very happy with results.



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    Washington Plastic Surgery
    Plastic, Hand, and Reconstructive Surgery

    12800 Bothell-Everett Hwy
    Suite 260
    Everett, WA 98208

    425.316.5080

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