Skin and Soft Tissue Cancer Reconstruction

Dr. Lindsey Webb is a board-certified plastic surgeon in Atlanta who has extensive experience with surgical excisions of benign and malignant skin lesions, including removal of cysts, atypical moles, and reconstruction following Mohs surgery or larger skin and soft tissue cancers. From small, cosmetically undesirable facial moles to large wounds that require transfer of muscle or skin grafts, Dr. Webb helps her patients achieve the best aesthetic and functional results possible.

Based on one’s diagnosis, there may be different modalities recommended for sarcoma, melanoma, or non-melanoma skin cancer, like squamous cell carcinoma or basal cell carcinoma. Physically removing the lesion by excisional surgery almost always occurs and then evaluating lymph nodes, chemotherapy or radiation therapy may also be recommended in certain cases.

Many small surgical excisions are performed in the office under local anesthetic, allowing you to go home immediately after the procedure. In more involved cases, hospital-based surgery may be required. If you require surgery, Dr. Webb will work with you to create a treatment plan that supports your needs and she will coordinate with the other surgeons on your team to keep the process smooth for you.

Depending on the severity and location of the cancer, skin cancer reconstruction options will vary from simple closure to flaps.

Excision and closure with sutures

Excision with a skin graft: A skin graft is a thin piece of skin taken from one area and secured to prepared recipient site.

Adjacent tissue transfer: If the affected area is larger, excision is often followed by local tissue transfer. This is skin and tissue that is moved or rotated in from an area next to the wound to help close it all in one stage, when it would otherwise be too tight to just stitch it closed it directly.

Regional flap: Skin/muscle/fascia nearby that is partially released to close a larger wound, i.e. using the latissimus muscle from the back to cover a wound on the chest/breast.
Free flap: Skin/fascia/muscle that is completely removed from a donor site with an artery and a vein and transferred to the recipient site, where the artery and vein are reconnected to blood vessels under the microscope. The flap is then shaped and inset with sutures and the donor site is closed directly with sutures or possibly a skin graft.
More complex wounds may require more than one procedure (or “stage”) depending on the location and blood supply of the area and to achieve a satisfactory outcome. Dr. Webb has performed thousands of skin grafts, tissue transfers, and flaps and will discuss the pros and cons of each procedure for which you may be a candidate.

After your skin cancer has been removed and any primary reconstruction is completed. A dressing or tape may be applied to your incisions. During your recovery, incision sites may be sore, red or drain small amounts of fluid. It is important to follow all wound care instructions such as cleansing and applying topical medications exactly as directed. You will be able to return to light activity as instructed by Dr. Webb but try to limit movement that may stress your wound or sutures for two weeks. Please make sure to keep your incision sites clean and well-protected.

Following Dr. Webb’s instructions is essential to the success of your surgery. It’s important that the surgical incisions are not subjected to excessive force, swelling, abrasion or motion during the time of healing. Avoiding nicotine products completely for six weeks before and six weeks after surgery is important to prevent wound-healing complications. Good blood sugar control in patient with diabetes helps decrease infection and other complications.

Dr. Lindsey Webb has extensive experience rebuilding and reconstructing areas of the face and body that have been treated using surgical excision from surgical oncologists and Mohs surgeons. Her goal is to minimize the appearance of the scar while restoring function, symmetry and natural harmony.