|  | |
|
Skin cancer most commonly occurs on sun-exposed areas of the body. The face is frequently affected, and the area around the eyes and cheek is the most commonly involved region. Basal cell carcinoma accounts for more than 90% of skin cancers involving the eyelids. Squamous cell carcinoma is the next most common skin cancer in this area. There are good (less aggressive) and bad (more aggressive, invasive) variants of both of these cancers. Fortunately, for most of these skin cancers, early and meticulous excision is successful in eradicating the disease. Basal cell carcinomas (see photos) do not metastasize (spread) to remote areas of the body. Malignant melanoma and sebaceous cell carcinoma occur very infrequently but have the potential to metastasize.
There are two basic approaches to basal cell and squamous cell carcinoma (see photos) excision. Skin cancer removal can be performed at the time of reconstruction and the tumor margins examined ("frozen sections") to ensure complete removal. Alternatively, microscopic-assisted resection may be performed by a dermatologic surgeon ("Mohs' surgery"). This technique offers the potential advantages of less tissue removal and slightly greater confidence of complete cancer resection. Recurrent disease can occur with any type of resection, so patients should have periodic examinations following their surgery.
Following Mohs' resection, reconstruction is performed within 3 to 4 days. The complexity of reconstruction will, of course, depend on the size and location of the defect. The main goal of repair is to restore adequate eyelid, brow, or facial function. Every attempt is also made to maximize the resulting cosmetic performance. (see photos of Eyelid and Facial Reconstruction) Occasionally, secondary surgical procedures are necessary to modify excessive scarring or to improve the position of the eyelid.
Once you have had a skin carcinoma removed from your face, you should have regular examinations by your dermatologist, primary care physician, or ophthalmologist. If you have had one skin cancer, there is a 30% chance that you will develop another. In people who have more than one such cancer, the average number of skin cancers that they develop over time is four.
Exposure to harmful irradiation from the sun is the major risk factor for skin cancer development. Sporadic, intense sun exposure can be more harmful than consistent, intermediate exposures. Even on cloudy days, the harmful effects of the sun should not be underestimated. The sun's rays are most dangerous between the hours of 10 a.m. and 3 p.m. It is almost never too late in life to start avoiding solar damage.
Some specific recommendations:
- Apply a good sunscreen with at least a sun protection factor (SPF) of 15-30 or greater to the face and area around the eyelids. Apply lightly to the forehead to avoid experiencing eye irritation with perspiration.
- Replace the sunscreen during the day if you are in the water or exercising strenuously.
- When outdoors, wear a wide-brimmed hat with a dark, non-reflective cloth surface beneath the brim to minimize reflective rays.
- Wear wraparound sunglasses with 100% UV blockage to protect the eyelids from lateral rays.
- Perform self-examinations in the mirror and bring any new lumps, bumps, and non-healing or tender areas to your physician's attention.
- Help prevent skin cancers in others by sharing these tips with your family and friends.
Stephen R. Klapper, M.D., F.A.C.S. is a board certified Ophthalmologist and has completed extensive fellowship training in Ophthalmic Plastic and Reconstructive Surgery. In addition to his clinical practice Dr. Klapper has published numerous scientific articles in peer reviewed journals and presented several papers at regional, national, and international meetings on topics related to the field of eyelid and facial plastic surgery. Dr. Klapper's practice is limited to adult and pediatric cosmetic and reconstructive eyelid and facial surgery, tear duct surgery, orbital disease, thyroid eye disease and the anophthalmic patient. Dr. Klapper also has extensive experience performing facial Botox® injections and Restylane® lip and facial fold injections.
| |
Contact our office to discuss your eyelid problem with Dr. Klapper or a member of his staff. (317) 818-1000
