What Are the Different Types of Skin Cancers That Can Occur around the Eyes?
The most common types of skin cancer that occur around the eyes are basal cell carcinoma, squamous cell carcinoma, and melanoma. If you have an eyelid lesion/bump that has been growing, bleeding, ulcerating, or causing loss of eyelashes, it would be prudent to seek evaluation with Dr. Shannon S. Joseph of the lesion. Depending on her examination findings, Dr. Joseph may recommend a biopsy of the lesion to determine whether it is benign or cancerous. Read more about eyelid lesions.
If you have been diagnosed with an eyelid skin cancer, surgical removal of the cancer is the treatment of choice for most patients. This is most commonly performed by a Mohs dermatologic surgeon who partners with Dr. Joseph. The Mohs procedure removes the skin cancer while checking in real time if the margin of the removed tissue is clear of cancer cells. If there are residual cancer cells along the margin, another ring of tissue is removed. This process continues until the margin is completely clear of cancer. Some types of skin cancers are not suitable for the Mohs procedure. For these cases, Dr. Joseph will perform the resection of the cancer and send the margins to be reviewed by a pathologist to determine margin clearance.
After the skin cancer has been removed, the specimen is examined by a pathologist to ensure that the skin edge is cancer-free. Once the cancer is determined to be completely removed, the reconstruction procedure will begin. This usually occurs on the same day or next day of the skin cancer removal. If the patient is undergoing the Mohs procedure, a bandage will be placed over the surgical site, and the patient will proceed from the Mohs dermatologic surgeon’s office to Dr. Joseph’s procedure/operating room as scheduled. This typically happens on the same day or next day.
The exact surgical plan of reconstruction is determined by the size, depth, and tissue involvement of the skin cancer. Most skin cancer defects can be reconstructed using local skin flaps that move skin from facial areas of more laxity into the defect. Sometimes a skin graft (taken from a non-adjacent area of more laxity) is necessary in reconstruction. Here is a review written by Dr. Joseph describing the Mohs reconstruction process and some of the commonly used techniques for reconstruction and scar management.
Skin cancer reconstruction around the eyes can be much more nuanced and challenging than the rest of the face and body. The eyelid skin is the thinnest skin in the body and there are many anatomic structures around the eyes with three-dimensional contour that needs to be preserved. In addition, the surgeon must use techniques specifically designed to maintain function of the eyelids and health of the eyes to achieve the best outcome.
Dr. Shannon S. Joseph is a fellowship-trained oculofacial plastic surgeon who specializes exclusively in plastic surgery around the eyes and face. In addition, Dr. Joseph is a board-certified ophthalmologist, which means she also has a keen understanding of what it takes to protect the health of the eyes and always takes this into consideration when performing eyelid surgery.
Prior to starting her private practice, Dr. Joseph was on faculty at the Johns Hopkins Hospital and the University of Michigan and has performed thousands of skin cancer reconstruction around the eyes at these institutions with outstanding outcome. It is for these reasons that other doctors routinely refer their patients with skin cancers around the eyes to Dr. Joseph, as they can attest to the superb results of her work. Learn more about why patients choose us.
This procedure may be performed with patients awake, under twilight anesthesia, or fully asleep. We individualize the plan for anesthesia based on patient preference and the patients’ overall health.
Surgical recovery varies from person to person, but most patients can return to work a week after surgery. Most patients may experience mild discomfort for the first few days and take Tylenol as needed. Following surgery, patients will be seen in the office approximately 5-10 days later to evaluate healing. Bruising and swelling will be present after surgery. Minor swelling can persist for several weeks. Please refer to our additional resources for general pre-operative and post-operative instructions to ensure that your surgery and recovery goes as smoothly as possible.
This procedure is usually covered by most medical insurances.
Schedule a Consultation
If you have been diagnosed with skin cancer of the eyelids and surrounding areas and looking to schedule skin cancer resection and reconstruction, please contact us to schedule a personal consultation with Dr. Joseph. She will perform a comprehensive evaluation and work with her dermatologic surgery colleagues to coordinate every step of your care. We take care of patients from Troy, Birmingham, Bloomfield Hills, West Bloomfield, Rochester Hills, Rochester, and the rest of Metro Detroit and Southeastern Michigan.