BCC Basal Cell Carcinoma Surgery in Southwest Sydney by Plastic Surgeons
Basal cell carcinoma (BCC) is the most common type of skin cancer and affects millions of people in Australia and around the world. Basal cell skin cancer arises from a type of cells called “basal cells” located at the base of the epidermis. It usually arises in sun-exposed areas including the face, neck, arms, and hands. Nevertheless, basal skin cancer can occur anywhere in the body.
The malignant skin lesions can appear as shiny skin growths, non-healing wounds, or can even resemble a scar. They might grow big enough to cause disfigurement and skin deformity. BCC Surgery to remove skin cancer requires experience and skills to ensure optimal outcomes, especially when the tumour is located in a visible area.
Sydney Specialist Plastic Surgeons Dr Varun Harish, Dr Hari Alani and Dr Michael Kernohan use surgical techniques and reconstructive methods to remove skin tumors and maintain the appearance of the skin. They perform a range of Skin Surgery in locations across Sydney, Southwest Sydney and Southern Highlands. The Pure Visage Plastic Surgery Main Clinic is located in Gregory Hills.
What is BCC – Basal Cell Carcinoma?
Basal Cell Carcinoma (BCC) is the most widely prevalent form of skin cancer around the world. It is classified as a nonmelanoma skin cancer, along with Squamous Cell Carcinoma (SCC).
BCC arises from a special type of skin cells called the “basal cells”. These are cells that reside just under the superficial layer of the epidermis. Basal cells generally give rise to new skin cells that migrate to the outermost superficial layer of the skin.
DNA damage to basal cells due to UV radiation or any other cause can lead to cancerous mutations. The newly formed malignant cells multiply without control and can develop into a variety of forms (outgrowth, flat growth, tumour).
Although malignant, BCC tends to grow slowly compared to squamous cell cancer. They are less likely to spread and metastasize to other body organs (bones and lymph nodes). Nevertheless, in rare cases, BCC can lead to serious complications if not treated early by surgical removal.
What are the Symptoms of BCC?
Knowing how basal cell skin cancer looks helps you be more aware of what to look out for when examining your body for signs of skin cancer. This is a practice that everyone should do routinely.
Although the skin lesions most commonly occur in sun-exposed body areas, BCC can still develop anywhere on your body.
BCC can be tricky to detect. It might resemble a typical looking skin wound or just your routine skin bump. Basal cell carcinoma usually appears like:
- A Non-healing skin wound, possibly with raised edges
- A shiny patch-looking scar
- A skin bump or tumour, usually shiny, transparent, or pinkish
- A red-pink skin patch that persists
Looks alone might not be enough to diagnose basal cell carcinoma. Many times, it can look like squamous cell carcinoma or any other type of skin cancer. In any case, if you notice a new suspicious skin growth, you should never delay visiting your doctor. Early detection, skin biopsy, and excision surgery are the key to the successful treatment of skin malignancies.
What Are The Risk Factors of Basal Cell Carcinoma?
Several factors increase your risk of developing basal skin cancer, such as:
- Light skin: Having a fair skin tone means you have less melanin. Melanin is our skin pigment, and it is protective against ultraviolet radiation. The less melanin you have, the more you are at risk of BCC.
- Sun exposure: Sunrays contain UV radiation, which can be damaging to cellular DNA. Staying in the sun for a prolonged time without using sunscreen increases your chances of basal cell carcinoma.
- Tanning beds: Indoor tanning and solarium also involve harmful radiation that damages skin cells
- Age: the older you are, the higher your risk of BCC
- Immune deficiency: like having leukemia or lymphoma
What Are The Treatment Options for Basal Cell Carcinoma?
Treatment for basal cell cancer depends on many factors. Low-risk BCCs, meaning those who don’t extend beyond the superficial skin layers can be treated with surgical removal alone.
Less invasive options include cryotherapy (with liquid nitrogen) and laser surgery. Please Note that we do NOT OFFER CRYOTHERAPY at this clinic.
Recurrent lesions and high-risk BCCs, with cancerous tissue extending into deeper layers or distant organs, might require radiation therapy in addition to surgical treatment.
Surgical Excision of BCC
Our surgeons follows several surgical techniques for the treatment of basal cell cancers:
Curettage and electrodesiccation for BCC (not currently offered Dr Kernohan)
This is the gold standard way for treating superficial basal cell carcinoma. It involves the use of a “curette”, which is shaped like a small scooping device, to scrape off the skin lesions layer by layer. After that, your surgeon uses an electric needle to burn the base of the wound and eliminate residual cancer cells and reduce the risk of recurrence.
Mohs Surgery for BCC (not offered by Dr Kernohan)
This surgery treats non-melanoma skin cancer and can be used as a treatment for basal cell and squamous cell cancers. In Mohs micrographic surgery, your doctor sends the tissue sample directly to the lab for a rapid inspection under the microscope. If the edges of the sample contain only normal healthy tissue (no cancer cells in the surgical margin), then your doctor resumes the surgery and closes the wound. If not, then your doctor removes more tissue from the edges and sends them back to the lab until they are free of cancer. Mohs surgery has the advantage of letting your doctor remove as little normal tissue as possible during surgical excision.
NOTE: Dr Kernohan refers to a dermatologist for Moh’s Surgery
Surgical Excision for BCC by Dr Kernohan
This is one of the most common ways to treat non-melanoma skin cancers like basal cell carcinoma. In an excisional surgery, Dr Kernohan uses a surgical blade to make an elliptical incision around the malignant skin lesion. He then removes the abnormal tissues with a surgical safety margin of 2-4 millimeters, to ensure that no cancer cells are left behind. The tissue sample is then sent to the pathology lab for inspection. If the surgical margin is free (contains no malignant cells), then no further surgery is needed. If cancerous cells are detected in the surgical margin, then a second surgical excision might be needed.
Non-Surgical Treatment Options
If you have a low-risk BCC or superficial basal cell carcinoma, then less invasive techniques might include a range of non-surgical treatments like PDT – Photo Dynamic Therapy, Laser or Cryotherapy (NOTE – These methods are NOT PERFORMED at Pure Visage clinic)
Radiation therapy: In cases of advanced basal cell carcinoma and aggressive tumours, skin cancer surgery is sometimes done in conjunction with radiation therapy to treat the malignancy.
The Pure Visage team can refer you to another medical specialist for these Non-Surgical Treatments.
Medical Treatment for high-risk Tumours
In case of metastatic, invasive tumours, or high-risk basal cell cancer, surgery for skin cancer might not be enough. Your cancer care team might add medications to your BCC treatment plan:
- Chemotherapy: Toxic chemicals that interfere with the growth of basal cell carcinoma
- Targeted therapy: Advanced medications that specifically target receptors on the malignant cells of BCC
The effective treatment of advanced basal cell cancer involves a multidisciplinary approach that usually involves a plastic surgeon, dermatologist and oncologist. Together, they will put the best treatment for non-melanoma skin cancer, whether it’s squamous cell carcinoma or basal cell carcinoma. Management of basal cell cancer aims to cure the malignancy and reduce recurrence rates.
How To Prepare for BCC Surgery
During Your First Consultation With Dr Kernohan
The first time you come in to get a suspicious lesion examined, your surgeon will start by visually inspecting the lesion. He will then ask you a few questions such as:
- When did you first notice the lesion?
- How fast has it been growing?
- Did it change shape? color? features?
- Does it itch or cause any pain?
Basal cell carcinoma can greatly resemble squamous cell carcinoma and other malignant and non-malignant skin lesions. So, your plastic surgeon can only be sure by performing a biopsy. Sometimes, if the lesion is small enough, a biopsy will remove the entire tumour, so no further surgery will be needed. If the lesion is large or located somewhere tricky, like near your nose, eyelids, or lips, then Dr Kernohan will likely schedule your skin surgery on another day.
Day of Skin Cancer Surgery
Whether you’re getting Mohs surgery or standard excision, both surgeries are considered one-day operations. This means that you will most probably not spend a night at the hospital. You can usually go about your life right after the procedure.
Dr Kernohan will instruct you regarding stopping blood-thinning medications before your procedure.
Mohs micrographic surgery and standard excision are done with the help of local anesthesia, so you will be awake during the procedure. In some cases, when the tumour is large or located in a sensitive location, you might be put to sleep.
After surgery, a friend or a family member should help you get home since you might be under the influence of sedatives.
Recovery After BCC Surgery
Recovery time after Mohs surgery or standard excision varies depending on the size, location, and depth of the primary lesions.
In general, the surgical wound heals in 1-3 weeks. You can usually return to work the next day after your skin cancer surgery. Larger wounds or those located in annoying areas, like the legs or hands, might require that you take more time off work.
You should not physically limit yourself after skin cancer surgery. You can move around, walk, and jog, as long as your surgical incision is not in the legs or feet. It is advisable, though, that you keep your wounds protected at all times to avoid any trauma.
What Are the Risks and Potential Complications Of Basal Skin Cancer Removal Surgery?
BCC removal surgery risks that might rarely occur include:
- Bleeding
- Wound Infection
- Cosmetic deformity – this is the top reason why a plastic surgeon is the right doctor to treat basal cell carcinoma. Facial tumours can invade the nose, lips, eyelids, or ears, causing tissue destruction and deformities after removal.
- A plastic surgeon is specifically trained to remove such cosmetically challenging lesions and perform facial reconstruction as needed. Less scarring, and better cosmetic outcomes.
- Recurrence – Recurrent lesions may sometimes occur in the same location or other locations in the body
Find out more about the risks and complications of plastic surgery from Dr Kernohan’s page.
How much is BCC Skin Cancer Removal Surgery in Sydney?
Estimating the cost of skin cancer surgery can sometimes be hard. Basal cell carcinoma can develop in any size and in any location. Therefore, more technically demanding BCCs (like facial basal cell carcinoma), will need more time and effort to remove. Moreover, facial tumors specifically often necessitate reconstructive procedures.
That being said, skin cancer surgery costs can only be estimated after your surgeon examines your lesion. You can get an estimated quote from the team by calling the clinic.
Medicare and insurers usually cover the costs of skin cancer surgery, regardless of the type (melanoma, nonmelanoma, BCC, SCC, or others).
Find out more information about Skin Cancer Removal Prices.
Contact Dr Kernohan’s team to set up an appointment or to get a cost estimate for your procedure.
Will Medicare cover my surgery?
In some cases and if you meet the eligibility criteria, Medicare might cover your surgery. Find out more about Medicare item numbers here.
You should also know that there are multiple payment plan options available to help you fund your surgery.
Dr Varun Harish FRACS (Plas) – Plastic Surgeon
