Skin Cancer

Skin cancer is the most common form of cancer, with over half a million new cases being diagnosed each year. Most skin cancers occur in exposed areas of the body, such as the head and neck, arms and legs. 

The most common cause of skin cancer is exposure to the sun. Living in South Florida, we are daily exposed to large doses of ultraviolet rays that damage our skin, cause us to age prematurely, and may lead to the development of skin cancers.

No one is immune to the development of skin cancer, but some individuals are more likely to develop skin cancer. These individuals include those 

· With fair skin, freckles, light hair, and light eyes

· With numerous moles

· With a history of a severe sunburn at an earlier age

· With a personal or family history of skin cancer

· Who live closer to the equator where the sun is more intense

· Whose occupation or lifestyle causes them to be outdoors during the peak hours of 11AM to 3PM

Types of Skin Cancer

There are three main types of skin cancer, although other forms do exist. The most common form is basal cell carcinoma. Fortunately this is also the skin cancer with the best prognosis. It tends to grow slowly and does not often spread to lymph nodes or other parts of the body.

The next most common type of skin cancer is squamous cell carcinoma. If not treated early and properly, this form of skin cancer may spread and become life-threatening.

Melanoma is less common than squamous cell or basal cell carcinomas, but it is by far the most deadly. It tends to spread to lymph nodes and to other organs, and is frequently life-threatening.

Recognizing Skin Cancer

Skin cancers may vary widely in appearance. They may arise from moles or other skin lesions that have existed harmlessly for many years, or they may arise from seemingly normal skin. If you have any lesion on your skin that is new, changing, itching, crusting, bleeding, or growing, you should be examined immediately.

Diagnosing Skin Cancer

The most important step you can take in skin cancer prevention and treatment is to be examined by a trained physician. Dr. Revis has extensive training in the diagnosis and treatment of all types of skin cancer and can initiate treatment for you. To diagnose skin cancer, part or all of it must be removed, or biopsied, and sent to a pathologist for examination under a microscope. 

Dr. Revis will also examine your entire body for other suspicious lesions and will examine your lymph nodes for enlargement.

If you have a lesion you are worried about or are in the high risk group for the development of skin cancer,  this page will give you a basic understanding of the procedure and the results you can expect. However, Dr. Revis feels it is extremely important to individualize treatment to your specific circumstances, therefore it is recommended that you visit our office for a consultation. You are also invited to email Dr. Revis with your questions, or we will mail you more detailed information regarding skin cancers.

The Consultation

During your initial consultation, Dr. Revis will inquire about your medical history, prior procedures, medications, allergies, and the specific characteristics of the lesion in question. It is very important that you be thorough when providing your medical history, as this information helps to prevent complications during your care. When asked about medications, be sure to include any vitamin or herbal preparations, as these can affect your blood pressure and clotting ability. Honesty regarding your use of tobacco and alcohol is also very important, as these may have a profound impact on your recovery period and your ability to heal following your procedure.

After reviewing your medical history, Dr. Revis will discuss your concerns, priorities, and motivations as well as your fears. After examining you, Dr. Revis will be able to offer advice and options for your treatment. He will explain the advantages and disadvantages of the different options you have before you. If you have medical insurance, this will often pay for any procedure you may need.

At the completion of your consultation, Suzanne, our Patient Coordinator, will give you a written estimate of the cost of your procedure and will instruct you in how to obtain pre-approval from your insurance company. At this time, you will also have the option to schedule your procedure if you so choose. The decision to undergo surgery is a very important one, and the final decision should be given very careful consideration. Dr. Revis realizes the importance of this decision, and at no time will you be pressured to make a decision. You are also encouraged to bring your spouse, significant other, family member, or a friend to your consultation.

Where Your Procedure Will Be Performed

Dr. Revis has been granted staff privileges at seven local hospitals and outpatient surgery centers. In the interest of the safety of his patients, he only performs surgery in fully accredited facilities with the proper services and staff. Biopsies and the removal of small lesions may be safely performed in Dr. Revis' office.

Type(s) of Anesthesia

Anesthesia is an essential part of any surgical procedure and must be performed safely. General anesthesia is the deepest form of anesthesia. You are asleep, feel no pain, and will not remember the procedure. General anesthesia is rarely needed for the treatment of skin cancer, unless the lesion is very large or involves a sensitive structure such as the eyelids.

Deep intravenous sedation, called “twilight sleep,” is a combination of local anesthetic administered at the surgical site by Dr. Revis and intravenous sedation administered by the anesthesiologist. You breathe for yourself, but you are in a deep sleep throughout the procedure. You should feel no pain, and you should not remember the procedure. This technique is used for intermediate sized lesions.

The most commonly employed technique involves the use of local anesthetic injected at the surgical site with or without the addition of an oral sedative. You will be awake for the procedure and will remember the procedure, but you will feel no pain because of the local anesthetics injected by Dr. Revis.

Dr. Revis will discuss these options with you more thoroughly at the time of your consultation, and please ask him about anything you do not understand.

Details of the Procedure

If the lesion is rather large or is in a cosmetically sensitive area such as the face or involves a critical structure such as the eyelid, Dr. Revis may choose to first perform a biopsy of the lesion. This involves removing a small piece of the lesion in question and sending it to a pathologist for microscopic examination. 

If a biopsy is performed, you will return to the office in two to three days to receive the results and to discuss further treatment options. If the lesion is indeed cancerous, Dr. Revis will schedule a procedure to completely remove the growth.

When the entire growth is removed rather than biopsied, it is also sent to the pathologist for examination. If the lesion has been completely removed, no further treatment may be necessary.

Regardless of whether you have a biopsy or have the entire lesion removed, Dr. Revis will carefully close the incision to minimize your resulting scar. A sterile dressing will then be applied.

Products To Help You Heal

SinEcch- Arnica Montana is a natural product from Sweden which has been shown in clinical studies to reduce postoperative bruising and swelling. Begun the evening prior to surgery, this product is continued for four days postoperatively.

Regenerin Surgical Support- Specially formulated for the surgical patient, this antioxidant and vitamin preparation will provide your body with the necessary nutrients and antioxidants to assist in healing your surgical wounds. Begun seven days prior to surgery, this product is then continued for one month postoperatively. Many patients find this product so beneficial that they continue on the Regenerin Daily Dietary Supplement Program after their healing is complete.

Unjury- This protein powder contains 20 grams of protein per scoop, and is taken twice daily beginning two weeks preoperatively and continued four weeks postoperatively. It is an invaluable source of protein to provide your body with the basic building blocks necessary to form strong healed wounds. This product is also accompanied by a number of recipes for using this product with coffee, tea, milk, Crystal Lite, and Jell-O.

ScarGuard- A combination of hydrocortisone, silicone and Vitamin E, this product is painted on your scars topically like nail polish beginning three weeks after surgery, and it helps your scars fade so that they fade as much as possible.

All of these products are available for purchase in our office. Please ask us about these products and others if you have any further questions about whether or not these would be beneficial for you during your healing period. 

After Your Procedure

Skin cancer excision is usually an outpatient procedure, unless a more extensive reconstruction is required. After recovering in the recovery room for approximately one hour, you will be able to go home in the company of a friend or family member.

You should plan to take it easy following your surgery. No strenuous activities, heavy lifting (over 20 pounds), aerobic exercises, swimming, contact sports, tennis, or golf should be planned for the first several weeks. As Dr. Revis monitors your recovery, he will advise you when it is safe to resume specific activities.

Your sutures will be removed by Dr. Revis in four to seven days following your procedure. Dr. Revis will then schedule you for regular checkups to monitor the site for recurrence of cancer or for the appearance of any new growths or changing lesions.

Please call (954) 630-2009 for further information or email Dr. Revis.

Email: DrRevis@SouthFloridaPlasticSurgery.com

Skin Cancer Reconstruction Photo Set 1

Squamous Cell Carcinoma of the nasal tip excised via Mohs micrographic technique and reconstructed with a full thickness skin graft, pre-reconstruction and three months post-reconstruction