Skin Cancer

Skin Cancer Before & After Photos – PG 5

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Skin Cancer Patient 41


This patient was referred to Dr. Bhama by a Mohs surgeon for treatment of a large, aggressive squamous cell carcinoma of the scalp. On preoperative photos, noticed the large lesion of the left scalp. Options were discussed and the patient elected for excision in the operating room followed by reconstruction once definitive analysis of the margins were found to be negative for cancer. Dr. Bhama clear the cancer in the operating room. Because of the aggressive nature of the cancer, this resulted in a large defect of the scalp measuring over 5 cm in diameter. Reconstruction was performed using a combination of adjacent tissue transfer with flaps as well as Integra, and skin grafting. An early postoperative result is shown demonstrating excellent camouflage of the scars. No revision surgery was performed. The patient was happy with the result. Notice preservation of frontalis muscle function as well as symmetry of the brow.


Skin Cancer Patient 42


This patient presented to Dr. Bhama with a chief complaint of a scaly lesion of the right brow. Dr. Bhama performed biopsy in clinic, which demonstrated basal call carcinoma (skin cancer). Dr. Bhama arranged for the patient to have Mohs surgery for removal of the cancer. The defect photos are shown here, demonstrating a defect of the right lateral forehead. Dr. Bhama performed transposition flap reconstruction. Very early post-operative photos are shown. Notice the preservation of the brow position and brow symmetry. The patient was very happy with results, and the scar will continue to improve with time. No revision surgery or dermabrasion were performed.


Skin Cancer Patient 43


This patient was referred to Dr. Bhama for reconstruction of a large nasal defect after Mohs surgery for basal cell carcinoma. She requested that her entire face not be included in the photos. Pre-op photos demonstrate a large defect of the nasal ala extending to the cheek. Options were discussed with the patient for reconstruction, and she elected for paramedian forehead flap. Dr. Bhama performed paramedian forehead flap reconstruction using auricular (ear) cartilage grafts to reconstruct the nasal valve. An advancement flap was used to reconstruct the cheek defect. Surgery went well, and early post-op pics are shown. Notice the excellent nasal contour. She was very happy with cosmetic and breathing results.


Skin Cancer Patient 44


This patient was referred to Dr. Bhama for reconstruction of a large nasal defect following Mohs surgery. On pre-op photos, notice the large, full thickness defect of the right nasal ala and soft tissue triangle. This presented a reconstructive challenge because of the involvement of the alar rim. Options were discussed, including skin grafts, paramedian forehead flaps, melolabial flaps and more. She did not wish to undergo forehead flap or melolabial flap. The patient elected for composite grafting. A large composite graft was taken from the patient’s right ear, consisting of a layer of cartilage and skin. The inner lining was recreated with a vestibular lining advancement flap. Post-operatively, the patient recovered uneventfully. Post-operative photos are shown demonstrating take of the graft. There is some alar notching, but the patient was very happy with results and did not desire revision. Her nasal breathing was normal.


Skin Cancer Patient 45


This patient was referred to Dr. Bhama by a Mohs surgeon to assist in management of a large lower lip cancer. Pre-op photos are shown demonstrating a large mass of the lower lip. The patient underwent Mohs surgery by a Mohs surgeon. The defect photos are shown demonstrating a near total defect of the lower lip vermillion. Dr. Bhama performed adjacent tissue transfer closure using the patient’s inner lip lining for reconstruction. Neck dissection was also performed with Dr. Shikary to remove lymph nodes in the neck given the risk of spread. Post-operative photos are shown demonstrating an excellent reconstructive result. Notice the contour of the lip is preserved. The patient has excellent oral function and was happy with results of the reconstruction.


Skin Cancer Patient 46


This patient was referred to Dr. Bhama following Mohs surgery for reconstruction of a large scalp defect. On pre-operative photos, notice the large scalp defect. Options were discussed with the patient, and he elected for adjacent tissue transfer closure (local flap) under local anesthesia. Surgery went well, and he was very happy with the results. Early post-operative photos are shown. The scar will continue to fade with time.


Skin Cancer Patient 47


This patient presented to Dr. Bhama with a large defect of the right nasal tip, soft tissue triangle, and ala. Options were discussed and the patient elected for paramedian forehead flap. Dr. Bhama used auricular (ear) cartilage graft to strengthen the nasal valve and prevent alar retraction (notching). Surgery went well, and early post-operative photos are shown. The patient was very happy with the aesthetic result and could breathe well through his nose. The swelling of the flap will continue to improve with time.


Skin Cancer Patient 48


This patient was referred to Dr. Bhama for management of a forehead defect following Mohs surgery. Options were discussed with the patient and she elected for adjacent tissue transfer using O to T flap. Final post-op result in shown. She was happy with the cosmetic appearance of the scar.


Skin Cancer Patient 49


This patient underwent Mohs surgery for a skin cancer on the left ear. On pre-op photos, notice the defect of the auricular (external ear) helical rim. Options were discussed and the patient elected for local flap reconstruction. Dr. Bhama performed surgery under local anesthetic. The patient did well, and was very happy with the results. Early post-operative results are shown.


Skin Cancer Patient 50


This patient was referred to Dr. Bhama for reconstruction of a large nasal defect following Mohs surgery for skin cancer. On pre-op photos, notice the large defect of the nose down to cartilage. Options were discussed with the patient, and she elected for skin grafting. Dr. Bhama performed a full-thickness skin graft of the wound. Post-operative photos are shown demonstrating an excellent result. The patient was very happy and had no difficulty breathing through her nose.


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