BCC Basal Cell Carcinoma Surgery in Southwest Sydney by Dr. Kernohan
- Do you have shiny skin growths?
- Some wounds are not healing?
- Suffering due to skin cancer?
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 – 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 the best cosmetic outcomes, especially when the tumour is located in a visible area.
Specialist Plastic Surgeon Dr. Michael Kernohan is one of the best skin cancer surgeons in Sydney, Australia. He uses scar minimizing surgical techniques and reconstructive methods to remove skin tumors and restore a normal skin contour.
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 normally 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.
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 every now and then.
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 normal 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.
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
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.
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.
Dr. Kernohan 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, Dr. Kernohan 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.
Dr. Kernohan, being a plastic surgeon, uses specialized surgical techniques to remove skin cancer. His cosmetic techniques allow him to minimize scarring and deformity. This is especially true for skin cancer of the face, where a tumour can invade the nose, cheeks, or lips, causing severe deformities.
Such cases of complicated skin cancer can only be handled properly by a plastic and reconstructive surgeon. Advanced reconstructive techniques can ensure that you get the best cosmetic outcome of your skin cancer surgery.
If you have a low-risk BCC or superficial basal cell carcinoma, then less invasive techniques might include common treatments like:
- Laser therapy: Also sometimes referred to as “laser surgery”. This is when Dr. Kernohan uses intense medical laser light to burn the skin lesion.
- Photodynamic therapy or PDT: This includes the use of a topical photosensitive gel that’s then activated by shining specialized light at it. Once activated, the ingredients will burn and kill the cancer cells.
- Cryotherapy: Also referred to as cold therapy or freezing therapy for basal cell carcinoma. This involves the use of liquid nitrogen, an extremely cold material, to freeze and kill skin cancer cells.
Radiation therapy: In cases of advanced basal cell carcinoma and aggressive tumours, skin cancer surgery is sometimes combined with radiation therapy to treat the malignancy.
Dr Kernohan can refer you to a 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.
The first time you come in to get a suspicious lesion examined, Dr. Kernohan 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, Dr. Kernohan 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 you for skin surgery on another day.
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 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?
In general, BCC removal surgery is safe and does not involve any major risks. Some of the risks that might rarely occur include:
- Wound Infection
- Cosmetic deformity – this is the top reason why a plastic surgeon is the best 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 might sometimes occur in the same location or other locations in the body. The risk of recurrence is minimized by choosing a surgeon specialized in treating skin cancer and recurrent tumours.
Find out more about the risks and complications of plastic surgery from Dr Kernohan’s page.
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 Dr. Kernohan 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 Dr Kernohan’s 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 financing options and payment plans available to help you fund your surgery.
BCC Surgery FAQs – Questions about BCC Surgery
Can basal cell carcinoma be easily removed?
- Basal cell cancer can fairly easily be removed with standard surgical excision or Mohs surgery. The challenge is in reconstructing the healthy tissue and reducing scarring.
How long does BCC surgery take?
- The time of BCC surgery can range between a few minutes and an hour or more, depending on where the cancer is located. BCC invading the nose, for example, can require extensive reconstruction.
Is basal cell carcinoma surgery painful?
- BCC surgery is not particularly painful. During surgery, an anesthetic will be used. During recovery, painkillers are usually enough to suppress any pain in the first couple of days.
Does basal cell carcinoma grow deep?
- Basal cell carcinoma can become invasive and extend into deeper skin layers if not treated in time.
What is the survival rate of basal cell carcinoma?
- The prognosis of basal cell carcinoma is usually very good. This means that the survival rates are very high when BCC is treated in time.
What is considered a large basal cell carcinoma?
- A large basal cell carcinoma is that measuring more than 2 cm in diameter.
Are basal cells itchy?
- Basal cell carcinoma can lead to itching in some cases.
What happens if Basal cell carcinoma is left untreated?
- If left untreated, there’s a chance that skin cancer will invade deeper layers of the skin and muscle. More aggressive basal cell carcinomas can extend to distant organs as well.
How fast does basal cell carcinoma spread?
- BCC is generally considered a small growing tumour, and takes time to grow and spread to other organs. On average, BCC tumours can grow at a rate of 1 cm per year. This might be faster or slower depending on your specific type of cancer.
What’s worse, basal cell or squamous?
- Both basal and squamous cell cancers are considered malignant non-melanoma skin cancers. Squamous cell carcinoma is regarded as being more dangerous since it has more potential to spread to other organs.
How do they cut out basal cell carcinoma?
- Curettage and electrodesiccation, standard wide excision, and Mohs surgery are 3 common ways to surgically remove BCC.
Is basal cell carcinoma fatal?
- Patients with basal cell skin cancer usually recover if the standard treatment is not delayed. BCC lesions usually grow at a slow rate and are less likely to spread compared to squamous cell carcinoma. Nevertheless, a medical evaluation and early diagnosis always carry a better chance of survival.
Can basal cell carcinoma come back?
- The recurrence rate of basal cell carcinoma is somewhat high – around 40%. This means that in every 10 people who have a BCC tumour removed, the cancer recurs. The location of the recurrent basal cell lesions is usually different from the primary tumour.
What is an aggressive BCC?
- An aggressive basal cell carcinoma is a form of BCC that tends to quickly grow in size and depth and spread to other body regions, usually before a diagnosis is made. This is why it is important to not leave any suspicious skin lesions unchecked.
Is Basal Cell Carcinoma benign or malignant?
- BCC and SCC are both malignant tumours. Basal cell cancer is, however, usually slow-growing, and hence, surgical removal leads to a complete cure in most cases.
Further Reading about BCC Skin Cancer Surgery
- What is the rate of recurrence for basal cell carcinoma (BCC)?
- Basal Cell Carcinoma
- Basal cell carcinoma – Symptoms and causes
- Skin cancer types: Basal cell carcinoma overview
- What Are Basal and Squamous Cell Skin Cancers? | Types of Skin Cancer
- Mohs Surgery – The Skin Cancer Foundation.
- Mohs surgery of basal cell carcinoma–a critical review
Dr Michael Kernohan – Specialist Plastic Surgeon in Sydney NSW
Dr Michael Kernohan is a Sydney Plastic, Reconstructive and Cosmetic Surgeon providing a wide range of services from skin cancer to cosmetic surgery for the face, nose, breast and body.
He also offers complex reconstructive procedures following trauma and a range of cancer treatments using the most innovative and up-to-date treatment options.
Dr Kernohan is able to care for both public and private patients and currently has appointments in five Sydney hospitals and has an additional leadership role as Director of Surgical Specialities.
His main clinic is located in Campbelltown and he has 4 other locations – Bowral, Liverpool, Surry Hills (city) and Gregory Hills opening in late May – servicing patients in Sydney Southwest and Southern Highlands.