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Skin Cancer Removal

Skin cancer removal involves surgically excising cancerous or abnormal skin lesions while preserving both health and appearance. Depending on the size, depth, and type of skin cancer, the procedure may include standard excision, Mohs surgery, or frozen section analysis to ensure complete removal. In cases where cancer removal leaves significant defects, reconstructive techniques such as local flap reconstruction or skin grafting may be required.

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Dr Terence Goh

MBBS

MMed

MRCS

FAMS

skin cancer skin cancer

When is Skin Cancer Removal Needed?

  • Basal cell carcinoma (BCC)

    Requires surgical removal to prevent local tissue damage while minimising scarring, especially in exposed areas like the face and neck.

  • Squamous cell carcinoma (SCC)

    Must be excised early to prevent deeper tissue invasion and ensure complete removal, reducing the risk of spread.

  • Melanoma

    Needs immediate surgical excision to prevent metastasis, as early treatment significantly improves long-term survival.

  • Precancerous lesions

    Removing abnormal growths like actinic keratosis helps prevent progression to invasive skin cancer while maintaining skin health.

Benefits of Skin Cancer Surgery

  • Complete cancer removal

    Surgery eliminates cancerous cells with techniques like Mohs surgery or frozen section analysis to confirm clear margins.

  • Minimising disfigurement

    Careful excision and reconstruction techniques preserve appearance while ensuring full cancer removal.

  • Improved healing and function

    Reconstructive options such as skin grafts or local flaps restore tissue integrity, promoting better healing and functional outcomes.

  • Preventing cancer progression

    Early excision stops skin cancer from invading deeper structures, reducing the risk of recurrence or spread.

Surgical Techniques

Standard Excision

For small or contained lesions, excision with a safety margin is performed to remove cancerous tissue. The wound is then closed using direct sutures or, in some cases, left to heal naturally.

Mohs Surgery

Mohs surgery is a specialised technique performed when precise cancer removal is required, especially in delicate areas like the face. It involves removing layers of skin and examining each layer under a microscope until a clear margin is achieved.

Frozen Section Analysis

When cancer extends beyond what is visible on the surface, frozen section analysis helps guide removal by assessing tissue margins in real-time to ensure complete excision while preserving healthy skin.

Reconstruction After Skin Cancer Removal

  • Local Flap Reconstruction

    For large defects, healthy adjacent tissue is repositioned to cover the wound. This technique maintains skin texture and colour match, especially for areas like the nose, eyelids, and lips.

  • Skin Grafting

    A thin layer of skin is taken from another part of the body and placed over the wound. Skin grafting is performed when local flap reconstruction is not feasible, or when extensive tissue loss requires additional skin coverage.

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Preparing for the Procedure

Consultation and Planning

A thorough consultation assesses the type and location of the lesion, as well as the best surgical and reconstructive options. If additional tests or margin analysis are required, they will be discussed in advance.

Pre-Surgical Guidelines

Patients should stop blood-thinning medications at least two weeks before surgery to reduce the risk of bleeding. Smoking cessation is recommended four weeks prior, as smoking can impair circulation and delay healing. Patients should inform their surgeon of any allergies to tape, sutures, or anaesthesia to avoid potential complications during or after the procedure.

Step-by-Step Procedure

1. Anaesthesia Administration

The procedure is performed under local anaesthesia, intravenous sedation, or general anaesthesia, depending on the extent of excision and reconstruction needed.

2. Cancer Removal

Small, contained skin cancer lesions are removed using standard excision with direct closure, ensuring complete removal while keeping scarring minimal. For larger or ill-defined cancers, Mohs surgery or frozen section analysis may be performed to confirm clear margins, ensuring all cancerous cells are excised while preserving as much healthy skin as possible.

3. Reconstruction and Wound Closure

If the wound is small, simple suturing is usually sufficient to close the incision with minimal scarring. For larger defects, local flap reconstruction or skin grafting may be required to restore both function and appearance, especially in delicate or visible areas.

4. Incision Closure and Post-Surgical Dressing

Sutures are carefully placed to follow natural skin lines, helping to reduce visible scarring. A protective dressing or bandage is applied to support healing, protect the wound from infection, and promote better recovery.

Post-Procedure Care and Recovery

Immediate Care

Mild swelling, bruising, and discomfort are common in the first few days after surgery. These symptoms gradually subside as healing progresses. Patients should follow all wound care instructions and avoid touching the treated area to prevent infection and ensure proper recovery.

Recovery Timeline

In the first week, incisions begin to heal, and sutures may be removed depending on the location and extent of the procedure. By four to six weeks, scar maturation starts, and most patients can resume normal activities while continuing to monitor the healing process. In the long term, scars may take months to refine, and follow-up appointments are essential to monitor for any signs of recurrence and ensure optimal recovery.

Aftercare Recommendations

Sun protection is necessary to prevent further skin damage and reduce the risk of recurrence. Patients should use sunscreen and protective clothing when outdoors. To promote proper healing, avoid excessive movement or tension on the wound, as this can impact scar formation. Regular follow-ups are required for monitoring new lesions and maintaining long-term skin health.

Potential Risks and Complications

Scarring or changes in skin texture may occur, particularly with larger excisions. Infection or delayed wound healing is possible but can often be prevented with proper wound care. Some patients experience temporary or permanent changes in skin sensation or pigmentation. In skin graft procedures, there is a risk of graft failure, which may require additional intervention or secondary treatment.

Frequently Asked Questions (FAQ)

Will I have a scar after skin cancer removal?

While some scarring is inevitable, precise suturing and reconstruction techniques help minimise its visibility. Over time, scars soften and fade, and if needed, further refinement procedures can improve their appearance.

What is the risk of skin cancer returning after surgery?

The risk of recurrence varies based on the type, size, and stage of skin cancer. Early-stage basal cell carcinoma has a lower recurrence rate, while melanoma or aggressive squamous cell carcinoma carries a higher risk. Regular check-ups, self-examinations, and sun protection help reduce recurrence and detect new lesions early.

How soon can I return to work after skin cancer removal?

For small excisions, most patients return to work within a few days. Larger procedures, especially those requiring reconstruction, may need a week or longer for proper recovery.

Does skin cancer removal affect sensation in the treated area?

Some patients experience temporary numbness or tingling due to nerve involvement. In rare cases, permanent changes in sensation may occur, depending on the depth of the excision.

Can skin cancer spread to other parts of the body?

Some types, such as melanoma and advanced squamous cell carcinoma, can spread if left untreated. Early detection and complete removal reduce this risk significantly.

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Dr Terence Goh

Choosing to combine the intricate skills of microsurgery with aesthetic surgery, Dr Goh specialises in gynaecomastia, surgery of the Asian face, particularly Asian eyelid surgery and rhinoplasty.

Blending the precision of microsurgery with the artistry of aesthetic surgery, Dr Goh has a special interest in gynaecomastia, facial procedures, including ptosis and eyelid surgery, as well as rhinoplasty.

He also offers a full range of body contouring procedures such as mummy makeovers, breast augmentation, liposuction, and body sculpting—designed to help patients feel more confident and comfortable in their own skin.

Beyond aesthetics, Dr Goh remains active in reconstructive microsurgery, with expertise in breast reconstruction, head and neck reconstruction, and lower limb salvage—restoring both form and function where it’s needed most.

  • Bachelor of Medicine, Bachelor of Surgery, National University of Singapore
  • Master of Medicine, National University of Singapore
  • Member of the Royal College of Surgeons
  • Fellow of the Academy of Medicine, Singapore (Plastic Surgery)
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