Oftentimes the removal of a skin cancer can leave a significant soft tissue defect or opening. This is particularly distressing to people if it is on their face. As a result, most people in this situation elect to have the defect repaired. In general there are 3 approaches to treatment of soft tissue defects.
This process is managed by the patient, requires regular dressing changes and wound care until the area is healed. This usually takes 5-6 weeks.
This method is more useful when large surfaces need to be repaired, and is more suitable for shallow defects.
This method which is also known as flap surgery utilizes tissue from along side or close to the defect. A pattern is cut in the skin and underlying tissue and is then freed up and moved into the defect. The opening that is left behind is then closed by stretching the skin edges together. This type of repair is technically difficult but can provide the most natural results.
Defects that are close to important structures, such as the eyelid, lip or nostril, can cause a very noticeable disfigurement or functional problem if left to heal by secondary intention. In these situations, it is in the patient’s best interest to proceed with reconstruction with a flap or graft to prevent distortion.
Small to medium sized defects can be reconstructed in an office setting under local anesthetic. Typically larger defects or those that are on lower portion of the nose are best managed in an operating room setting. The choice of treatment depends upon multiple factors including the size, depth, location of the opening, the medical status of the patient, and patient expectations.