Skin Cancer Treatment and Aesthetic Repairs
Skin cancer is one of the most common types of cancer worldwide. It is particularly more frequent in individuals who are heavily exposed to sunlight. When the DNA structure of skin cells is damaged by environmental factors such as ultraviolet (UV) radiation or harmful chemicals, these cells begin to multiply uncontrollably, leading to skin cancer.
Other Types of Skin Cancer
Skin cancer usually appears on sun-exposed areas such as the face, nose, lips, ears, and hands. However, in some cases, it may also develop in areas not exposed to sunlight, such as the back, scalp, or genital region. This shows that skin cancer should not be associated with sun exposure alone.
1. Melanoma
Although melanoma is less common than other types of skin cancer, it is the most dangerous. It often presents with rapid changes in moles. If detected early, it can be successfully treated; however, at later stages, the risk of metastasis is quite high.
2. Basal Cell Carcinoma (BCC)
Basal cell carcinoma is the most common form of skin cancer, but the least likely to spread. It usually grows slowly, rarely metastasizes, and can be completely treated with early diagnosis.
Characteristics:
• Frequently seen on sun-exposed areas such as the face, nose, ears, and forehead.
• May appear as a shiny, pearl-like bump or a crusty, non-healing wound on the skin.
Treatment:
• Surgical removal of the cancerous tissue is the most effective method.
• In cosmetically sensitive areas, plastic surgical repair may be required after removal.
3. Squamous Cell Carcinoma (SCC)
Squamous cell carcinoma may progress more aggressively than BCC. In advanced stages, it carries the risk of spreading to lymph nodes or other organs. Therefore, early diagnosis is of critical importance.
Characteristics:
• Typically occurs in areas with prolonged sun exposure (face, lips, hands, scalp).
• Appears as a rough, scaly, firm lesion with a tendency to bleed.
Treatment:
• Surgical excision is the most effective method.
• After wide excision, reconstructive methods such as flaps or grafts may be required.
Causes of Skin Cancer
• Prolonged and unprotected sun exposure
• Artificial UV sources such as tanning beds
• Fair skin, which has weaker protection against UV damage
• Genetic predisposition and immune system disorders
Symptoms of Skin Cancer
• Moles that change shape over time and appear asymmetrical
• Skin spots that change color or darken
• Irregularly bordered growths larger than 5 mm in diameter
• Non-healing wounds, or areas that bleed or crust over
Diagnosis and Treatment Process of Skin Cancer
1. Diagnosis
Examination of skin lesions is usually carried out through dermatological evaluation followed by biopsy. A definitive diagnosis is made after pathological analysis.
2. Surgical Treatment
In skin cancers detected at an early stage, surgical removal of only the cancerous tissue is usually sufficient. In some cases, larger excisions may be necessary.
Aesthetic and Functional Repair After Skin Cancer
After removal of cancerous tissue, reconstructive procedures may be necessary in cosmetically and functionally important areas such as the face, nose, lips, eyelids, ears, and scalp. Plastic surgery reconstruction techniques are applied in these cases.
Repair Methods Applied
• Flap Technique: A piece of living tissue with preserved blood supply is transferred from a nearby area for repair. It provides natural results both aesthetically and functionally.
• Skin Graft Technique: A thin layer of skin, usually taken from areas such as the thigh, arm, or abdomen, is transplanted to the damaged area. Commonly used in small and superficial tissue defects.
Through these techniques, not only is cancer treatment achieved, but also the preservation of a natural appearance, reduction of scarring, and maintenance of functional integrity in the affected region.
Treatment is tailored individually, and the most suitable method is chosen based on the location and size of the lesion, as well as the patient’s overall condition.
Information on Sentinel Lymph Node Biopsy (SLNB) and Lymph Node Dissection (LND)
This page summarizes the evaluation and treatment options for lymph nodes in the armpit and groin regions for skin and soft tissue cancers (melanoma, cutaneous SCC/BCC, Merkel cell carcinoma, soft tissue sarcomas, etc.). The information is for general purposes only; personal medical decisions should be made following examination and multidisciplinary evaluation.
Why Are Lymph Nodes Important?
Skin and soft tissue cancers may initially spread to the regional lymph nodes draining the tumor area.
• Upper extremity (arm, shoulder, part of the back) and upper trunk: mostly drain into axillary (armpit) lymph nodes.
• Lower extremity (leg, hip, perineum/lower trunk): mostly drain into inguinal (groin) lymph nodes.
Diagnostic Pathway
1. Clinical examination and imaging: The armpit or groin on the relevant side is carefully assessed; ultrasound, advanced imaging, and/or needle biopsies are performed if necessary.
2. If no clinical growth/spread is detected:
• Sentinel Lymph Node Biopsy (SLNB) is performed.
3. If cancer is suspected in lymph nodes clinically, or if SLNB is positive:
• Depending on the case and tumor characteristics, regional lymph node dissection (LND) may be planned, or close follow-up / systemic-radiation therapies may be preferred according to modern guidelines. (Decision is made at a tumor board.)
What Is Sentinel Lymph Node Biopsy (SLNB)?
It is the procedure of identifying and removing the “sentinel” lymph node that first drains from the tumor site.
• Using nuclear medicine with special markers and/or blue dye, the sentinel node is detected.
• For the armpit: sentinel nodes are sought in the arm/chest areas.
• For the groin: sentinel nodes are sought in the thigh/hip-perineal drainage regions.
• If pathology is negative, additional surgery is usually not needed. If positive, further treatment options are discussed.
What Is Lymph Node Dissection (LND)?
If lymph node involvement is confirmed or SLNB indicates it, the affected lymph nodes are surgically removed.
Axillary (Armpit) Dissection
• Indication: Suspicion or confirmation of axillary spread in skin-soft tissue cancers of the upper extremity/upper trunk.
• Purpose: To control regional disease, clarify staging, and contribute to treatment in selected cases.
Inguinal (Groin) Dissection
• Indication: Suspicion or confirmation of spread to groin lymph nodes in skin-soft tissue cancers originating in the lower extremity/perineum.
• Purpose: Regional control and accurate staging. If necessary, plastic surgery techniques (e.g., sartorius flap transfers) may be used to preserve femoral vessels and provide soft tissue coverage.
How Is the Surgery Performed?
• Anesthesia: Performed under general anesthesia.
• Incisions: Made according to regional anatomy, preserving nerve and vascular structures.
• Drains: Temporary drains may be placed to reduce fluid accumulation.
• Duration and hospitalization: Varies depending on the case; usually requires short hospital stay.
Possible Risks and Side Effects
As with any surgery, risks are individual and will be explained in detail before surgery.
• Early stage: Bleeding, infection, seroma/lymphocele, wound healing issues, sensory changes, shoulder movement limitations (axilla), skin edge circulation problems.
• Late stage: Lymphedema (swelling in arm or leg), long-term sensory or movement limitations, recurrence.
• Lymphedema risk: Varies with tumor type, history of radiotherapy, body mass index, extent of dissection, and individual factors. It can be managed with early intervention and physiotherapy.
Postoperative Period and Rehabilitation
• Drain follow-up: Drains are removed when output decreases.
• Wound care: Keep sutures dry and clean, dressings should be done as instructed.
• Pain control and movement: Early controlled shoulder/hip-leg exercises are recommended.
• Lymphedema prevention:
• Keep the affected arm/leg elevated, avoid overuse.
• Skin care (protection from cuts/injuries, moisturizing).
• If needed, compression sleeves/stockings and manual lymph drainage.
• Avoid procedures that may obstruct lymph flow, such as blood draws/blood pressure measurements on the affected limb, tight jewelry, and prolonged heat exposure (according to your doctor’s advice).
About the Author
Prof. Dr. Osman Kelahmetoğlu
Specialist in Plastic, Reconstructive and Aesthetic Surgery
This article was prepared by Prof. Dr. Osman Kelahmetoğlu in light of scientific resources and clinical experience. You can contact for more information or to schedule an appointment.
Contact: iletisim@osmankelahmetoglu.com – 0 (533) 351 76 37