Facial skin surgery

Facial skin surgery comprises any surgery of the exterior skin of the face,. This is separate from maxillofacial surgery, which includes surgery to the jawbone and the skull. Facial skin surgery can be performed for medical reasons, such as cancer removal, or cosmetic reasons, such as the removal of cysts or other blemishes.

Mr Cascarini offers facial surgery for medical problems only but his skill provides an excellent cosmetic outcome. Your treatment begins with an initial consultation to confirm your diagnosis and then he will develop a surgical plan to remove the required tissue while minimising scarring as much as possible.

What conditions are treated by facial skin surgery?

• Skin cancers – the tumour and a healthy margin of surrounding tissue is removed to prevent the cancer from spreading.

• Epidermoid and pillar cysts – surgery is used to remove unsightly lumps and bumps caused by cysts beneath the skin. These cysts are benign sacs that are filled with viscous fluid. They do not pose a risk to health but may compromise function (an eyelid cyst may obscure vision) or cause problems with wearing spectacles or cause a loss of confidence.

• Lipomas – small sacs of fatty tissue just below the surface of the skin can be removed easily. Like cysts, these do not pose a threat to health, but may be removed for functional or cosmetic reasons.

• Moles – these are often removed for cosmetic reasons, but they may also pose a risk of skin cancer and are removed either for biopsies or to prevent problems in the future.

Facial surgery techniques

The technique chosen by Mr Cascarini will depend on the condition being treated.

Facial surgery techniques include:

• Excision – this is the most common form of facial skin surgery, in which tissue, such as a tumour or cyst, is simply cut away or removed from beneath the skin surface.

• Curettage and electrocautery – this is a highly skilled technique in which cells are scraped away using a sharp spoon like instrument, with the skin surface then immediately cauterised by a heated loop or needle to stop the bleeding.

• Mohs micrographic technique – this is a specialist cancer surgery technique that is used to minimise the amount of healthy tissue that is removed. The tumour is cut away in small sections, with each section immediately analysed under a microscope to check for cancer cells. Surgery is stopped as soon as no cancer is detected, reducing the need for a margin of error.

Skin grafts and flaps

If facial surgery involves the removal of a significant amount of tissue, it may be necessary to use a skin graft or a skin flap to repair the wound site.

  • A skin graft is a thin layer of skin that is taken from elsewhere on the body with an intact blood supply. Common source sites are behind the ears or from the inner thigh. The skin is stitched in place over the wound site and its blood supply is connected with the local blood supply near the wound.
  • A skin flap is neighbouring skin that is stretched over the wound site and stitched into place, retaining some of its original blood supply.

In both cases, the new skin is carefully selected to match the original area as closely as possible, and will heal and fade over time to blend in with its surroundings.

Mr Cascarini uses skin flaps extensively when performing facial reconstruction surgery in trauma and accident patients.