Surgery for facial skin tumors

Facial skin tumors can be benign or malignant, depending on the cell type and the risk of alteration over time.​

They are most often detected by the patient himself, or by his doctor, or by a dermatologist, who may ask a surgeon to perform an excision and repair procedure.

Benign lesions are surgically removed to limit the risk of malignant transformation.

Other benign lesions may be locally irritated, or remain esthetically unattractive due to their location .

When in doubt, these tumors can be biopsied beforehand to offer a definitive diagnosis.

Another type of skin tumor is one whose color and boundaries may vary over time, raising the possibility of a melanoma lesion, which may develop into a malignant melanoma.

– Basal cell carcinomas, for which exposure to the sun is a risk factor, evolve locally with progressive extension in surface area and depth. Around the nostrils, mouth, ears or orbital cavities, extensions may become infiltrative, with a much more severe course. However, these carcinomas are unlikely to metastasize.

– Squamous cell or squamous cell carcinomas, which can affect the face, hands and mucous membranes, with the risk of lymph node involvement and metastases.The surgical procedure will include a time for excision and a time for repair, depending on the extent of tissue loss. Depending on the aggressiveness of the malignant lesion, whether basal or squamous cell, tissue safety margins in healthy areas will be respected, with variations inherent to the topography and to each case.

Chirurgie des tumeurs cutanées de la face

The area to be repaired can be grafted with skin generally taken from the base of the neck or from areas of excess, such as the eyelids or the furrows behind the ears.

Grafting can have the disadvantage of bringing back skin of a different color, particularly on the face. 

Another technique is local plasty using a flap.
 A range of flap techniques are available to limit the final aesthetic impact of such a repair.

These procedures are performed under neuroleptanalgesia or truncal block anesthesia, or even under general anesthesia, very often on an outpatient basis.

Previous treatments must be carefully analyzed by the medical team to limit the risk of subsequent hemorrhage or thrombosis. All medications, particularly those aimed at the cardiovascular system, must be reported during the preliminary consultation, to limit the risk of secondary local or general complications. 

This type of procedure is followed by nursing care for two to three weeks, until definitive healing has taken place.

Results are optimized by avoiding exposure to the sun and using a sunblock. Scar massages may be suggested at a later stage.
 Complications such as infection, hematoma or tissue necrosis are always possible, although very rare. 

In most cases, these complications are perfectly manageable with time and slightly longer healing timeframes.

Dermatological monitoring is recommended, initially every six months, then annually, given the risk of recurrence of a lesion, or the appearance of an identical structure in other areas.

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