Skin Cancer

Skin Cancer Before & After Photos – PG 2

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Skin Cancer Patient 11


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 12


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.


Skin Cancer Patient 13


This young man was referred to Dr. Bhama by a Mohs surgeon for reconstruction following Mohs surgery to remove a skin cancer. The defect is a quite large and involves a very challenging region of the face because of its close proximity to the eyelids. Options were discussed and the patient elected for local flap closure (adjacent tissue transfer). Surgery went well and the patient recovered quickly. He was very happy with the results of surgery. Early post-operative photos are shown. His scar will continue to improve with time.


Skin Cancer Patient 14


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 15


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 16

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 17

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 18


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 19


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 20


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.


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