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Treatment of Multiple Skin Cancer Lesions

About Dr. Hootan Zandifar

Dr. Hootan Zandifar is board-certified in Otolaryngology and fellowship-trained in Facial Plastics and Reconstructive Surgery. Dr. Zandifar is the director of the Skin Center at the Osborne Head and Neck Institute based at Cedars-Sinai Medical Towers.

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About Dr. Ryan Osborne

Ryan F. Osborne, M.D. is the Director of Head and Neck Surgery at OHNI and is an internationally renowned expert in head and neck oncology. He has developed a special interest for the treatment of parotid gland tumors and focuses on the use of minimally-invasive techniques in the care of patients needing parotid surgery.

Question: I have multiple skin cancers on my face. Should I remove them all at once or at different times? 

Case Study

A male patient in his 60s is noted to have two separate skin cancers on the right side of his face. He has a larger squamous cell carcinoma on the cheek just below the eyelid and a basal cell carcinoma on the right side of the nasal tip. It was determined that in order to achieve the best cosmetic outcome the two lesions would have to be resected and reconstructed two weeks apart.

The patient underwent Mohs excision of the cheek scar first and subsequent reconstruction with Dr. Zandifar. Two weeks later, the patient underwent Mohs excision of the nasal scar followed by reconstruction with Dr. Zandifar. After reconstruction, both scars were treated with silicone-based gel and sunscreen as well as monthly treatment with IPL laser. Two months after reconstruction both scars are hardly noticeable and the patient is happy with the results.

Figure 1: Excision of squamous cell carcinoma of the cheek skin. The small red spot on the nose is a basal cell carcinoma that will be resected two weeks later. 

Figure 2: Two weeks after reconstruction of the cheek. The nasal defect skin cancer has been removed and another suspicious lesion biopsied. The healing scar on the cheek is also visible.  

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Figure 3: Two months after reconstruction of the nose and cheek by Dr. Zandifar.

Discussion

The majority of skin cancers tend to develop in areas of the skin that are frequently exposed to the sun. This means that the head and neck region is highly susceptible to developing skin cancers. It is also not uncommon for multiple skin cancer lesions to develop in these areas. Although it may seem convenient to remove and reconstruct multiple skin cancer lesions at once, it is advisable to approach each lesion separately in order to achieve a better cosmetic result. By approaching each skin cancer individually, the surgeon can focus his effort on reconstructing the facial architecture as well as promoting a natural appearance.

For optimal results, a reconstructive surgeon should also develop a customized plan for follow up care. This care typically includes laser treatment, silicone-gel application, and even steroid injections. It should also be noted that application of sunscreen to the entire face is not only important in improving the appearance of the scar, but also decreases the likelihood of developing another skin cancer in the future.

The physicians of the Osborne Head and Neck Institute are board certified in both otolaryngology and plastic and reconstructive surgery. This unique combination of training allows these surgeons to address both functional and cosmetic concerns concurrently.

To learn more about Dr. Hootan Zandifar or reconstructive surgery, please visit: www.ohniskin.com.

Contact a Physician at Osborne Head & Neck Institute

If you would like to speak with one of our physicians regarding this issue or another ear, nose, throat problem; or have other questions or concerns, please complete the contact form below or call us at 310-657-0123.

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