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About the procedure Excision Basal Cell Carcinoma And Squamous Cell Carcinoma

Our Philosophy on Excision of BCC and SCC

At AR Plastic Surgery, our approach to the excision of Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC) prioritises complete and safe removal while maintaining function and considering reconstruction. We understand that managing skin cancers extends beyond the removal of the lesion, requiring thoughtful planning and a personalised approach that considers the patient’s diagnosis, general health, and anatomical location of the lesion.

The surgeons who operate at AR Plastic Surgery have experience managing skin cancers, including high-risk and complex cases. Excision is performed with attention to achieving clear margins while preserving surrounding tissue when appropriate. For lesions on the face, scalp, ears, or hands, reconstructive methods are considered during planning to help maintain tissue structure and function.

Our philosophy is founded on providing each patient with clear, honest information. We ensure patients understand their diagnosis, the nature of the proposed procedure, the rationale behind excision, and the implications for reconstruction and recovery. Every step of the process is explained, from pre-operative preparation to post-operative care. This informed approach promotes patient confidence and supports shared decision-making.

Understanding BCC and SCC

Basal Cell Carcinoma (BCC) is the most common type of skin cancer and arises from basal cells in the lower layer of the epidermis. BCCs tend to grow slowly and are less likely to spread to other areas of the body, but they can cause local tissue destruction if left untreated. They are commonly found in sun-exposed areas such as the face, neck, and upper body.

Squamous Cell Carcinoma (SCC) originates from squamous cells and has a higher potential to spread compared to BCC, particularly when located on the lip, ear, or in immunosuppressed patients. SCCs may appear as scaly, crusted lesions or as rapidly growing nodules. Prompt excision is recommended to prevent deeper invasion or spread to lymph nodes.

Diagnosis is typically made via a biopsy. Once confirmed, a treatment plan is established based on the size, type, location, and pathology features of the lesion. At AR Plastic Surgery, we assess whether standard surgical excision is suitable or if more extensive resection and reconstruction will be needed, especially for high-risk or recurrent cases.

Surgical Planning and Technique

The planning for BCC or SCC excision includes evaluating the lesion’s size, depth, and proximity to vital structures. A standard excision typically includes the lesion and a margin of surrounding healthy tissue to ensure complete removal. The margin width is determined based on pathology guidelines and clinical assessment, with the aim of achieving histologically clear margins.

The surgical technique and reconstruction are customised to each patient’s needs. For small lesions, direct closure may be sufficient. For larger or anatomically complex areas, local flap reconstruction or skin grafting may be required. The goal is to minimise distortion, protect function, and provide durable coverage.

The surgeons who operate at AR Plastic Surgery utilise reconstructive methods that maintain tissue integrity and alignment with surrounding structures. Particular attention is given to lesions on the face, nose, lips, or ears, where cosmetic and functional considerations are more complex. Where reconstruction is needed, the approach is discussed thoroughly during the consultation, outlining incision placement, expected scars, and the anticipated course of healing.

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What to Expect During the Day of the Procedure

Patients are admitted to the surgical facility, where the clinical team assists with final preparations. This includes reviewing the surgical plan, confirming consent, and marking the lesion and planned excision margins. The procedure is scheduled based on the complexity of the case and individual needs.

The procedure may be performed under local or general anaesthesia, depending on the size and location of the lesion, the extent of tissue removal, and the complexity of reconstruction. Local anaesthesia is commonly used for smaller, less complex excisions, particularly those on the trunk or limbs. For larger or facial lesions requiring flap reconstruction, general anaesthesia may be recommended.

The lesion is removed with planned margins, and the tissue is examined. If margins are not clear, further excision may be needed. The wound is then closed, dressings are applied, and patients are monitored in recovery. Before discharge, they receive post-operative instructions, including care of the surgical site and activity guidelines. Early follow-up may be arranged to check grafts or flaps if used.

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Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors, including the individual’s genetics, diet and exercise. Some images may have the patient’s tattoos, jewellery or other identifiable items blurred to protect patient identities.

Aftercare and Recovery

After surgery, care is focused on helping the wound heal and checking for any signs of problems. Dressings should be kept in place as instructed, and patients are given clear guidance on how to care for the surgical site—this includes bathing, managing discomfort, and recognising signs of infection or delayed healing.

Follow-up appointments are arranged to check how the wound is healing and to discuss the results of the tissue examination. If the lesion has been completely removed, no further treatment is usually required. If the results show that more tissue may need to be removed, this will be discussed along with any other options, which may include referral to other specialists if needed.

Recovery time depends on the type and size of the surgery. Patients are advised to avoid heavy activity until the wound is more stable. Stitches are usually removed within 5 to 10 days. Ongoing skin checks and sun protection are recommended to help reduce the risk of future skin cancers. Patients are encouraged to report any new or changing skin spots early.

Potential Risks

As with any surgical intervention, the excision of BCC and SCC involves risks that are discussed with patients before the procedure. These may include:

  • Infection
  • Bleeding or haematoma
  • Wound breakdown or delayed healing
  • Scarring
  • Changes in skin sensation
  • Recurrence of the lesion
  • Incomplete excision
  • Asymmetry or cosmetic irregularities
  • Complications related to anaesthesia (if applicable)

A thorough risk assessment is conducted before surgery, and patients are educated on how to recognise potential post-operative concerns. All excised tissue is sent for examination to confirm the completeness of excision. Patients are provided with instructions for managing the wound and reducing exposure to UV radiation, helping to support healing and prevent future skin damage.

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