• 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

Skin Cancer Patient 1

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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 2


This patient underwent Mohs surgery for removal of a skin cancer from the nose and was referred to Dr. Bhama for reconstruction. On preoperative view, note the full thickness defect of the left nostril. This region involves an area of the nose called the soft tissue triangle which is challenging to reconstruct. Because the defect was through skin, cartilage, and mucosa, all three layers had to be reconstructed. Dr. Bhama performed complex reconstruction including cartilage graft from the right ear, advancement flap using mucosa to reconstruct the inside of the nose, and paramedian forehead flap for the skin. The patient’s one week post-operative result is shown. He has excellent flap take and contour. The fullness of the flap will improve with time, as will the appearance of the forehead scar. He has no issues with breathing through his nose and happy with the result. Notice the right ear donor site heals without any obvious deformity after cartilage removal.


Skin Cancer Patient 3

Skin Cancer Patient

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 her 4 month post-operative photo. No revision surgery or dermabrasion has been performed. 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 4

Skin Cancer Patient

This patient underwent Mohs surgery for a squamous cell carcinoma (skin cancer) of the lower lip. The patient was referred to Dr. Bhama for reconstruction of the defect. On the pre-operative photo, notice the large defect of the lower lip down to the orbicularis oris muscle (muscle of the lip and mouth) involving > 60% of the lower lip. Options for reconstruction were discussed and the patient elected for vermilionectomy and sublabial mucosal advancement flap reconstruction. Shown is a very early post-operative result. She is very happy with the cosmetic appearance and retains complete function of her lower lip. She has no issues with eating, drinking or speech. The scar will continue to fade with time. No revision surgery, steroid injections, or dermabrasion have been performed.


Skin Cancer Patient 5

Skin Cancer Patient 1

This patient was diagnosed with squamous cell carcinoma of the lower lip. Dr. Bhama performed complex full thickness excision of a large portion of the lower lip followed by reconstruction. This is an early post-operative photo demonstrating excellent contour of the lower lip. Note the continuity of the vermillio-cutaneous border. The patient retains excellent function of the lower lip.


Skin Cancer Patient 6


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 7

Skin Cancer Patient 3

This patient was referred to Dr. Bhama for reconstruction of the lip following Mohs surgery for skin cancer. Pre-operatively, there is a large defect of the central lip with exposed muscle. Dr. Bhama performed vermillionectomy and sublabial mucosal advancement flap. An early post-operative picture is shown demonstrating excellent lip contour. Lip function is preserved and the patient is pleased with the result.


Skin Cancer Patient 8


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 9


This patient presented to Dr. Bhama with an abnormal appearing lesion of the upper lip. Biopsy confirmed squamous cell carcinoma in situ. He was referred to dermatology and underwent Mohs surgery. He returned to Dr. Bhama with the defect in the upper lip noted in the pre-op photo. Notice the large defect of the upper central lip extending to the underlying muscle. Dr. Bhama performed a sublabial mucosal advancement flap under local anesthetic in clinic. Post-operatively, the patient has complete function of his lip and is pleased with the result.


Skin Cancer Patient 10


This patient presented to Dr. Bhama with a skin cancer of the lower lip. The cancer was resected by a Mohs surgeon resulting a in wound of the lower lip. Dr. Bhama performed wedge resection and reconstruction of the lower lip. Shown are early post-operative photos. The patient has an excellent cosmetic result and good function of the lower lip. He was very happy with the result.


Skin Cancer Patient 11


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 12


This patient underwent Mohs surgery for excision of a basal cell carcinoma from the left side of the nose and was referred to Dr. Bhama for reconstructive options. Pre-operatively, note the defect of the left nasal ala involving the alar rim. This challenging defect requires repair of the nasal valve to prevent long-term nasal obstruction. Options were discussed and he elected for paramedian forehead flap reconstruction. He wished to avoid general anesthesia, so surgery was performed in our surgical procedure room under local anesthetic. He underwent forehead flap reconstruction of the defect using auricular (ear) cartilage graft for reconstruction of the nasal valve. Shown is a very early post-operative photo. Swelling of the nasal reconstruction site will continue to improve. Note the excellent alignment of the brow.


Skin Cancer Patient 13


This patient underwent Mohs surgery for removal of a large squamous cell carcinoma (skin cancer) of the scalp. The deep layers of the scalp were found to be involved with cancer, so she was referred to Dr. Bhama for clearance of the remaining cancer and reconstruction. On the pre-operative view, notice the 4.0 cm in diameter scalp defect nearly down to the skull. The patient underwent removal of the deep layers of the scalp under local anesthetic with Dr. Bhama. Once the final analysis of the specimen confirmed clear margins, Dr. Bhama performed O to Z flap reconstruction, recruiting tissue from adjacent regions of the scalp to reconstruct the defect. She healed beautifully, and her 5 week post-operative photo is shown. The scar will continue to improve with time. No revision surgery, dermabrasion, or steroid injections were performed. The patient was very happy with the outcome.


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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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