Skin Cancer

Skin Cancer Before & After Photos – PG 4

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Skin Cancer Patient 31


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 32


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 33

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 34

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 35


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 36


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 37


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 38


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 39


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 40


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.


Photo Disclaimer: Before & After photographs shown on this site are actual patients who have given permission to have their photos published. They are for illustrative purposes only. Individual results vary. Reputable surgeons do not guarantee outcomes and no prediction of outcome is implied. Individual healing characteristics and unexpected complications can affect the outcome of any surgery.

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