What kind of surgery would you recommend to remove two spots due to skin cancer? (photos)

Question

Hello! I had to remove two spots due to skin cancer. I have keloid scars. Would it be possible to do skin grafting for these ? The scars are right above my breasts so it looks pretty bad and I wanted them to be completely unnoticeable

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

Generally speaking, scars can be improved with a combination of surgery and/or lasers and microneedling with PRP. Below is a more detailed reference list of the treatments available. I recommend getting a formal evaluation with a scarring expert to determine which is best for your specific case. Best, Dr. Emer   1. Vascular lasers (BBL, Yellow laser, V-Beam, Excel V) 2. Fractional lasers (Fraxel, Erbium, CO2, Halo) 3. Microneedling/PRP 4. Silicone-based scar gels with growth factors 5. Excision / revision surgery   See an expert to develop a treatment plan that works for you. Best, Dr. Emer​

Nelson Lee Novick, MD · Answer

Unfortunately, at least for the present, no mature scars, such as keloid scars, can be erased entirely with any current treatments--either alone in combination. Significant improvement, however, is possible. First-line treatment typically consists of injections of anti-inflammatory agents, such as triamcinolone+/-5-FU to shrink the keloid and to lighten its color from pinkish/purplish to a more off-white to ivory color. This alone often constitutes a significant improvement in appearance. Professional microneedling accompanied by prescription strength topical pigment promoters, such as tyrosine and lanatoprost, may then be tried to better blend the color or texture of the treated areas with the surrounding normal skin. Revision surgery runs the risk of leading to even larger stretch scars and stitch tracks and even recurrent keloid formation. Make sure to consult with a board certified cosmetic dermatologist.

Benjamin Barankin, MD, FRCPC · Answer

At present, the gold standard of treating keloid scars in your skin type and in this location would be injecting cortisone +/- 5-FU and +/- liquid nitrogen preceding that. A skin graft is not an option, and surgical scar revision not a great idea either due to high risk of recurrence of the keloid and possibly even bigger in size. Once the injections have more or less flattened the keloid, then a vascular laser (e.g. Excel-V, PDL, etc) can be used to reduce pink-purple color that may be left.

What kind of surgery would you recommend to remove two spots due to skin cancer? (photos)

Answers (4)

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