The Skin Cancer Foundation Journal

MAY 2012

The 2012 edition of The Skin Cancer Foundation Journal features medically reviewed, reader-friendly articles such as tanning, the increasing incidence of skin cancer diagnoses among young women, & the prevalence of melanoma among white males over 50.

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Page 33 of 103

BEAUTY Secrets of a DARRICK ANTELL, MD T he most important factor in attaining a great result from plastic surgery is the surgeon you choose. Working closely with dermatologists (especially Mohs surgeons) who remove skin cancers, plastic surgeons are often an integral part of the treatment team, ensuring optimal closure of wounds and the best possible cosmetic result. If your dermatologist feels you need recon- structive surgery after cancer removal, odds are he or she will have a short list of preferred plastic surgeons you can choose. Sometimes the best plastic sur- gery is the one you don't perform. Although surgeons are typically not paid for not operating, earlier this year a patient sent me a full payment check with a lovely thank you note for having advised her not to have surgical reconstruction after her Mohs procedure. This highlights the option of letting wounds heal on their own. If the wound is large enough, this can't always be done, but in this particular case, I had advised the patient that I could see her periodically to observe the natural healing, and we could intervene with a skin graft or another procedure at a later date if needed. Having carefully chosen this approach, we were all delighted 32 with the final outcome, with no reconstruction required. THE DAY OF SURGERY In my practice, I often see patients before they have skin cancer surgery to review post-treatment options. Then on the day of their cancer removal, we list the patient on our schedule on whether to refer the patient to the plastic surgeon can be delayed until the cancer surgery is completed. Perhaps the biggest advantage of a two-surgeon approach, as in other cancer operations, is that the primary surgeon need not be inhibited from removing as much tissue as needed. THE VALUE OF TEAMWORK Perhaps the biggest advantage of a two-surgeon approach, as in other cancer operations, is that the primary surgeon need not be inhibited from removing as much tissue as needed. The primary surgeon knows that the plastic surgeon is there to back him or her up and take on the repair regardless of the size and location of the wound. Teamwork is the cornerstone of as a "possible" surgical case. After the cancer is out, the dermatologist may choose to repair the wound, or may refer the patient to us. Consider consulting a plastic surgeon with a private, on-site fully accredited operating room, which provides the flexibility to accommodate a surgical case on short notice. This allows better access to care, so the final decision good medicine; for example, in breast cancer surgery the plastic surgeon takes over after the breast is removed by another surgeon. Similarly, in skin cancer surgery the reconstructive plastic surgeon comes into the picture after removal of the malignant area. I regularly work with the patients of a number of local dermatologists. I also work directly with patients from out of town who have recently had skin cancer surgery; the patient or the surgeon often emails postsurgical photos before the visit so that we may better plan the reconstruction. THE RECONSTRUCTIVE PROCESS Two common reconstructive options are skin grafts and flaps. A skin graft SK IN CANCER FOUNDAT ION JOURNA L Plastic Surgeon Saving Face after Skin Cancer

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