Lewis Plastic Surgery: Gordon Lewis, MD
2331-A Robious Station Circle
Midlothian, VA 23113
Skin Cancer Surgery
Skin cancer is an increasing problem in our society. More than 3.5 million cases of skin cancer are treated each year and one in five people will develop skin cancer at some time in their life. Some types of early skin cancer are very easy to manage and can sometimes be treated without surgery, but as skin cancers get larger, it often requires surgical excision. Unfortunately, if left unchecked, some types of skin cancer can spread to distant areas of the body and ultimately cause death.
The removal of skin cancer can leave defects in the skin. Cosmetic surgery is an option for removing and repairing the defects caused by the removal of skin cancer. Most of these surgeries can be performed our office under local anesthetic, but in the case of larger procedures, we will recommend treatment in the operating room with anesthesia.
Basal Cell Carcinoma
Basal Cell Carcinoma is the most common type of skin cancer. This cancer often looks like an open sore, a dry scaly area, or a raised red bump. Luckily, it is very rare that basal cell carcinoma metastasizes (spreads) to distant areas in the body. Treatment is usually complete with surgical excision.
We can perform the excisions in our office and then reconstructs the defect at the same time. The contours of the area are taken into account in order to minimize any cosmetic changes to the affected region. After removal of a basal cell cancer, we will guide patients on techniques for decreasing scarring.
You will return to us until you are fully healed. Patients will need continued follow up for evaluation for new cancers. This is done through either their primary care physician or a dermatologist.
Squamous Cell Carcinoma
Squamous Cell Carcinoma is the second most common type of skin cancer. Like basal cell carcinoma, this type is often found on sun exposed areas of the body. These lesions often look like red scaly patches, open sores, or persistent scabs. These can bleed over time and will usually get larger over time.
There is a risk of spread to lymph nodes with squamous cell cancer. The risk is largely determined by the size of the cancer, the location, and the specifics of the actual cancer cells. Most squamous cell cancer is treated with excision of the primary lesion without the need for surgical evaluation of the lymph nodes.
Sometimes an MRI is used to help assess the regional lymph nodes. After removal of a squamous cell carcinoma, we will guide patients on techniques for decreasing scarring. We will see patients until they are fully healed. Patients will need continued follow up for evaluation for new cancers. This is done through either their primary care physician or a dermatologist.
Melanoma is the most deadly of the common types of skin cancer. This cancer is almost always curable if caught early in its course. However, if left unmonitored, this type of cancer will spread to the lymph nodes and then to different sites within the body. These usually arise from pigmented (brown) moles from the body. As the melanomas grow, there are usually visible changes that can lead to the suspicion of a mole being cancerous. Some of these changes include:
A- Asymmetry – the mole is not symmetric
B- Borders – the borders of the mole are irregular
C- Color – there is variation in the color within the mole
D- Diameter – is usually greater than ¼ inch (although they can be less)
E- Evolution- changes within a mole
If you note one or more of these findings within a mole, we can help you determine the likelihood of the mole being cancerous and may recommend biopsy of the lesion.
Melanomas are graded by the thickness of the cancer. Early melanomas (less than 1mm thick) usually are considered to have a very low potential to spread and are therefore treated primarily with wide local excision. As the melanoma gets deeper, the risk of lymph node metastases increases we recommend evaluation of the lymph nodes near the tumor site. We can perform a sentinel node biopsy at the time of the surgery to evaluate the regional lymph nodes for spread. This is done through a small incision and has relatively small risk to the patient.
If there is any spread of the melanoma, we must enlist the assistance of other medical providers. Surgical and medical oncologists are involved in cases that show evidence of spreading.
We have a good deal of experience of the removal of melanoma and will work with each patient and thoroughly explain each step. Often, the reconstruction of the defect requires advanced techniques to minimize the appearance of the scars. This varies greatly by location.
After removal of a melanoma, patients will need close follow up for at least two years. This is usually done with a combination of visiting us and a dermatologist. After two years, continued follow up with a dermatologist is needed indefinitely, but at a decreased frequency.
At the time of the consultation, we will closely examine your skin to determine the type and extent of the skin cancer. We’ll discuss in detail your health history, any medical conditions and your aesthetic goals once the cancer has been removed.
Surgical procedures are performed at an accredited outpatient surgical center or a local hospital. Dr. Gordon Lewis is affiliated with several local medical centers where his patients undergo surgery. He primarily operates at these locations:
Stony Point Surgery Center
Parham Surgery Center
He also has privileges at St. Mary’s Hospital and Henrico Doctors Hospital, but he operates there less frequently.
Initial consultations, follow-up appointments, and all non-surgical treatments and minor surgical procedures are performed at Lewis Plastic Surgery practice, which is located on the grounds of Johnson-Willis Hospital in Richmond, Virginia.
Will skin cancer surgery be covered by insurance?
Yes, the vast majority of skin cancer surgeries are covered under health insurance policies.
Every patient is required to attend an initial consultation before a procedure can be booked. Once you decide to proceed with surgery, we will assist you in finalizing a date and getting everything ready for surgery. We try to be as flexible as possible and will make arrangements to see you at Lewis Plastic Surgery on the grounds of Johnston-Willis Hospital within a few days after you contact us.
Gordon Lewis, M.D.
Dr. Lewis, a native of Richmond, prioritizes building honest, trusting relationships and providing personalized care for his patients.Meet Dr. Lewis