Skin Cancer

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 to Dr. Bhama by a Mohs surgeon following excision of a large melanoma in situ from the right cheek. Pre-operative photos are shown demonstrating a large, deep defect of the right medial cheek. This area can be very challenging to reconstruct given the proximity to the eyelid, and the facial nerve. Options were discussed with the patient and he elected for cervicofacial flap. Dr. Bhama performed a large cervicofacial flap advancement flap with a Z-Plasty in the neck to break up the scar. The patient tolerated the procedure well and went home the same day. Early post-operative photos are shown demonstrating an excellent result. Notice the lack of eyelid distortion, and the excellent contour of the cheek. The scar will continue to fade with time. The patient was very happy with results, and his facial nerve was completely intact.


Skin Cancer Patient 3


This patient was referred to Dr. Bhama by a Mohs surgeon for reconstruction after Mohs surgery for skin cancer. On pre-operative photos, notice the defect of the left nasal tip. Options were discussed with the patient and she elected for paramedian forehead flap. Intermediate photos are shown demonstrating the pedicle in place. Early post-operative photos are also demonstrated following division of the pedicle. Notice the excellent reconstruction result. The patient was very happy with both cosmetic and functional results and was able to breathe well through her nose. Her scar will continue to fade with time, and the fullness of the tissues will improve.


Skin Cancer Patient 4


This patient was referred to Dr. Bhama by a Mohs surgeon for reconstruction of a nasal defect following Mohs surgery for basal cell carcinoma of the nose. On pre-operative photos, notice the large defect of he nasal ala extending to the sidewall, and the separate defect of the sip and sidewall extending to the dorsum. Options were discussed, and the patient elected for paramedian forehead flap reconstruction. Dr. Bhama performed paramedian forehead flap reconstruction of both defects using auricular cartilage (ear cartilage) from the patient’s right ear to reconstruct the nasal valve. Intermediary photos are shown, demonstrating the forehead flap in place. Post-operative photos are shown demonstrating an excellent nasal contour. Notice the right ear appears completely normal as well following auricular cartilage harvest. The patient was very happy with the cosmetic result, and was able to breathe through his nose without difficulty.


Skin Cancer Patient 5


This patient was referred to Dr. Bhama for a mass on the right lower eyelid. Dr. Bhama performed biopsy which confirmed skin cancer (basal cell carcinoma). On initial photos, noticed the ulcerated mass of the right lower eyelid margin. Dr. Bhama referred the patient for Mohs surgery. Mohs surgery was performed and the patient returned to Dr. Bhama for reconstruction. On pre-reconstruction photos noticed the massive full-thickness defect of the lower eyelid. Most of the oral eyelid has been removed. The underlying muscle has also been removed as has the tarsal plate and conjunctiva. Options were discussed with the patient. Dr. Bhama performed tarsal conjunctival flap advancement with contralateral upper eyelid skin graft (Hughes procedure). Intermediate stage photos are shown and early postoperative reconstructive photos are shown. The patient has an excellent eyelid contour that will continue to improve with time. The swelling of the eyelid margin will continue to settle down. He has complete eye closure and was very happy with results. Notice the crescent shaped contour of the lower eyelid, appropriate amount of scleral show, and symmetry of the palpebral aperture.


Skin Cancer Patient 6


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 7


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 8


This patient was referred to Dr. Bhama for reconstruction of a large Mohs defect on the right side of the nose. She had a history of previous rhinoplasty. Because of her age and her history of previous nasal surgery, the decision was made to avoid local flaps. Options were discussed with the patient and she elected for Integra followed by full-thickness skin graft. Because of the close proximity of the defect to the nostril rim, nasal valve repair was also required. Cartilage was harvested from the patient’s ear. Surgery went well, and the patient underwent dermabrasion and was also referred to one of Dr. Bhama’s colleagues for laser treatment of the scar. Postoperative photos are shown demonstrating a well-healed scar, which should continue to fade with time. The patient was very happy with the results from a cosmetic and nasal breathing standpoint.


Skin Cancer Patient 9


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 10


This patient was referred to Dr. Bhama for repair of a Mohs defect after removal of a skin cancer. Options were discussed and the patient elected for local flap closure and dermabrasion. Post-operative photos are shown demonstrating an excellent result. The scar will continue to fade with time.


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