Skin Cancer

Skin Cancer Before & After Photos – PG 3

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Skin Cancer Patient 21


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.


Skin Cancer Patient 22


This patient was referred to Dr. Bhama by a Mohs surgeon following Mohs surgery to remove a large skin cancer from the nose, cheek, and lip. The resulting defect was substantial, and involved a portion of the nose, lip, and cheek. Options for reconstruction were discussed at length with the patient, including forehead flap, melolabial flap, skin grafting, and more. The patient elected for the least invasive and most expeditious method to reconstruct the wound and provide an adequate nasal airway. He did not wish to undergo general anesthetic. Dr. Bhama performed complex repair in clinic under local anesthetic without any sedation using several techniques. Skin grafting, adjacent tissue transfer, and nasal valve suspension were performed. Shown is a very early post-operative result, demonstrating coverage of the wound and an adequate nasal airway. The patient was very happy with results and was able to breathe well. The appearance of the wound will continue to improve with time.


Skin Cancer Patient 23


This patient was referred to Dr. Bhama by a Mohs surgeon after excision of a basal cell carcinoma resulting in a defect of the right nasal ala, soft tissue triangle, tip and sidewall. On preoperative photography, noticed the defect. Because of the importance of this area and breathing, nasal valve reconstruction was also required. Options were discussed with the patient and she elected for paramedian forehead flap. Dr. Bhama performed paramedian forehead flap reconstruction, and auricular cartilage grafting to augment the nasal valve. The postoperative result is shown. Noticed the excellent contour of the right nasal ala. The patient does not have any difficulty breathing through the nose. No revision surgery has been performed.


Skin Cancer Patient 24

Skin Cancer Patient

This patient was diagnosed with a large melanoma of the right neck. He underwent excision of the melanoma with a surgical oncologist and was referred to Dr. Bhama for reconstruction. A pre-operative photo of the melanoma is demonstrated. Following excision, the defect measured approximately 5 cm X 5 cm. Dr. Bhama performed a rhombic flap reconstruction. An early post-operative result is shown. The patient has excellent neck mobility and is very happy with cosmetic results. The scar will continue to improve with time.


Skin Cancer Patient 25


This patient underwent Mohs surgery for excision of 2 cancers on the upper lip. She was referred to Dr. Bhama for reconstruction. Dr. Bhama performed the reconstructive surgery. The procedure went well and the patient recovered uneventfully. She was very happy with the postoperative result. No revision surgery or dermabrasion was performed. Notice the nearly imperceptible scars.


Skin Cancer Patient 26


This patient was referred to Dr. Bhama by a Mohs surgeon for reconstruction of a nasal defect after Mohs surgery. On pre-operative photos, notice the large defect of the nasal tip, columella, soft tissue triangles and a portion of the nasal dorsum. Options for management were discussed and the patient elected for paramedian forehead flap reconstruction. Surgery went well, and very early (post operative day 7) pictures are shown. He was very happy with the cosmetic result and could breathe well through his nose. His scars will continue to fade with time.


Skin Cancer Patient 27


This patient was referred to Dr. Bhama for reconstruction after resection of a large melanoma from the nose. Options were discussed and he elected for paramedian forehead flap reconstruction. He underwent surgery and recovered well. Postoperatively, he was happy with the cosmetic result and was able to breathe well through his nose.


Skin Cancer Patient 28


This patient underwent Mohs surgery for removal of a basal cell carcinoma of the left nasal sidewall. On the preoperative photo, a large defect of the nasal sidewall is demonstrated. Options were discussed and she elected for transposition flap closure. Dr. Bhama performed transposition flap surgery under local anesthesia in our procedure room at Mill Creek. Postoperative photos were shown. No revision surgery was performed. The patient was very happy with results.


Skin Cancer Patient 29


This young woman underwent Mohs surgery for a skin cancer located very close to the eye and was referred to Dr. Bhama for reconstruction. On pre-treatment photos, notice the large, deep defect of the right medial canthal region. Because of the patient’s young age, and close proximity to the eye, this presented a reconstructive challenge. Options for reconstruction were discussed and Dr. Bhama and the patient elected for healing by secondary intention followed by dermabrasion. Early post-treatment photos are shown. The scar will continue to fade with time and the color will become less pronounced. The patient was very happy with the result. There was no distortion of her eyelid.


Skin Cancer Patient 30


This patient underwent Mohs surgery for removal of a skin cancer (basal cell carcinoma) from the nose and was referred to Dr. Bhama for reconstruction. On pre-reconstruction photos, notice the defect of the left nasal sidewall. Dr. Bhama discussed options with the patient, and she elected for bilobe flap reconstruction. Dermabrasion was also performed post-operatively. Early post-operative photos are shown demonstrating an excellent cosmetic result. The patient was very happy and the scar will continue to fade with time.


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