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Treating Eyelid Skin Cancer

Eyelid skin cancer is a common reason patients seek specialized care from Dr. Zoumalan. Dr. Zoumalan specializes in the removal of eyelid skin cancer and eyelid reconstruction. His extensive training using the advanced techniques in reconstruction and healing have allowed his patients to recover well from the procedure while providing a result as natural appearing as possible. Dr. Zoumalan has performed thousands of eyelid reconstructive surgeries and many of them have involved skin cancer and eyelid reconstruction.

Common Conditions:

The most common eyelid skin cancer is basal cell carcinoma, followed by squamous cell carcinoma and sebaceous cell carcinoma. Melanoma is also seen but not as common as basal cell carcinoma and the others. Basal cell carcinoma is most commonly seen in fair skinned individuals with a history of prolonged sun exposure. It is important to have any new bumps or moles around your face, eyelids and body evaluated by a dermatologist or by a plastic surgeon.

Mohs Surgery:

Dr. Zoumalan usually works with a dermatologist who is trained in Mohs surgery to treat eyelid skin cancer. Mohs surgery is a microscopically controlled surgery used to treat common types of skin cancer with a high cure rate (up to 95-97% in selected studies for basal cell carcinoma). It is one of the many methods of obtaining complete margin control during removal of a skin cancer using frozen section histology. Once a dermatologist completes the Mohs surgery on the patient, Dr. Zoumalan will then perform the eyelid reconstruction. There are various methods used in eyelid reconstruction, and they all depend on various factors:

1) Age of patient and the laxity of the eyelid tissue.
2) Amount of tissue missing (defect) after having the skin cancer removed.
3) Location of the defect (upper lid, lower lid, medial or lateral lid) and if it involves the tear duct system.

Depending on these factors, reconstruction can be performed by utilizing a variety of techniques to help fill in the missing area of skin. Dr. Zoumalan uses minimally invasive techniques to allow for optimal recovery and minimizing local trauma to surrounding healthy tissue. Dr. Zoumalan’s vast experience in reconstructive surgery allows for him to use several advanced techniques such as local advancement of tissue to fill in the defect, local skin and muscle flaps, and lid tightening techniques. Skin grafts may need to be used in selected cases as well.

Reconstructive Eyelid Surgery:

The surgery itself can either be performed in the office under local anesthesia or in the operating room. This all depends on the size of the lesion and how much tissue loss is expected. Larger defects and those that involve the tear duct system will require you to be sedated in the operating room. You and Dr. Zoumalan will discuss these options once you meet with him for your consultation. Dr. Zoumalan needs to perform a careful examination before your Mohs surgery and after it is removed in order to best prepare you for your reconstruction.

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    Preoperative Diagnosis: Right lower lid basal cell carcinoma that was biopsied in the office.

    Preoperative Diagnosis: Right lower lid basal cell carcinoma

    Procedure performed: Right lower lid excision of basal cell carcinoma and reconstruction using a myocutaneous advancement flap (Tenzel flap).

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    Preoperative Diagnosis: Left eyelid, medial canthal, and left cheek basal cell carcinoma.

    Procedure performed: Left eyelid, medial canthal, and left cheek reconstruction using myocutaneous advancement flaps.

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    Preoperative Diagnosis: Left lower lid basal cell carcinoma that was biopsied in the office.

    Preoperative Diagnosis:Left lower lid basal cell carcinoma

    Procedure performed: Left lower lid excision of basal cell carcinoma and reconstruction using a myocutaneous advancement flap (Tenzel flap).

  • image

    Preoperative Diagnosis:Left lower lid basal cell carcinoma.

    Procedure performed: Excision of left lower lid basal cell carcinoma, eyelid reconstruction using a Tenzelmyocutaneous advancement flap.