Skin Cancer in Beverly Hills
Surgical Intervention to Keep You Safe
A surprise to many people, the
skin is actually the largest organ of your body and plays a crucial role in
the health and proper functioning of the body. The skin’s primary
role is to act as the first line of defense for the body – protecting
it from damaging chemicals, harmful bacteria, biological contaminants,
dehydration, physical trauma, overheating, and ultraviolet radiation.
Although the skin is vital to the body’s health, it is also a vulnerable
organ and can sustain significant damage from unprotected exposure to
the harmful effects of the sun.
Skin cancer is the most common form of cancer in the United States, with
over one million cases of skin cancer diagnosed each year. According to
the American Cancer Society (ACS), one in five people will develop skin
cancer at some time in their life. These statistics highlight the importance
of skin cancer awareness and taking preventative measures to protect yourself
from damaging UV rays. However, prevention is not always enough –
if you have been noted to have a skin cancer, surgical intervention may
be necessary to remove the lesion. When undergoing treatment for skin
cancer, it is reassuring to be in a safe, comforting environment, and
to have complete faith in the skills and abilities of your plastic surgeon.
Dr. Joubin Gabbay M.D. and the entire team of compassionate and professional
individuals at Gabbay Plastic Surgery in Beverly Hills will guide you
and be by your side throughout your skin cancer treatment—from your
first initial consultation to your post-recovery healing. Dr. Gabbay has
years of extensive training and experience performing various skin cancer
procedures and implements the most cutting-edge surgical techniques and
advanced technology in order to preserve both your health and your appearance.
Options for Surgery
There are a wide variety of methods and treatments for skin cancer, depending
upon the particular type and degree of skin cancer the patient is suffering
from. During your initial consultation, Dr. Gabbay will conduct a thorough
medical evaluation and will create a customized treatment plan for you,
taking into consideration factors such as the degree to which your skin
cancer has grown, whether your skin cancer has metastasized, and your
overall physical and emotional health.
One of the main benefits of having a highly skilled plastic surgeon perform
your skin cancer surgery is that Dr. Gabbay understands the importance
of both physical and emotional healing. To this end, Dr. Gabbay will take
every possible measure not only to restore you to complete physical health
but also to ensure that your post-surgical scarring is as minimal as possible.
Dr. Gabbay focuses on the complete eradication of your skin cancer, while simultaneously providing the best
possible cosmetic outcome, and to creating a compassionate, caring environment
for your treatment. If you are concerned that you may have skin cancer,
or if you have been previously diagnosed with the condition, please call
Gabbay Plastic Surgery today and let us schedule your initial, complimentary
consultation with Dr. Gabbay.
Anatomy of the Skin
Human skin is made up of three primary layers: the epidermis, the dermis,
and the subcutaneous layer. The epidermis is the outermost layer of the
skin and is primarily made up of cells called keratinocytes, melanocytes,
and dendritic cells. Melanocyte cells produce a dark pigment called melanin,
which contributes to skin color and provides UV protection from the sun.
These cells are located at the bottom of the epidermis and have the potential
to turn into melanoma skin cancer.
The dermis consists mostly of connective tissue (structural tissue) and
is much thicker than the epidermis. The dermis is responsible for the
skin’s strength, pliability, and resistance, for regulating the
body’s temperature, and for providing the epidermis with nutrients
through its vascular network. The subcutaneous layer is below the dermis,
consists of a network of connective tissue and fat, and acts as a protective
cushion for the body.
Risk factors for both melanoma and non-melanoma skin cancer include:
Ultraviolet (UV) Radiation: Sun exposure is a significant contributing factor to the development
of skin cancer.
Skin Tone: people with lighter skin tones area at greater the risk for getting skin
cancer because of their increased sensitivity to UV rays
Gender: men are more likely to get skin cancers than women, although it is not
known why this is the case
Previous Skin Cancer: people who have previously had skin cancer are at a heightened risk for
getting skin cancer again
Immune System Suppression: the immune system helps the body fight off cancer, which means that people
with weakened immune systems have a higher risk for developing skin cancer
Xeroderma Pigmentosum: an inherited disease that affects the body’s ability to repair
damaged DNA skin cells. People who have xeroderma pigmentosum are at a
higher risk for getting skin cancer and must be especially careful about
exposure to UV radiation.
Risk factors specific to melanoma skin cancers include:
Moles: moles are essentially benign (non-cancerous) tumors and are generally
not a cause for concern; however, certain types do pose an increased risk
of developing into melanoma cancer.
Family Background: individuals with relatives who have developed melanoma skin cancer are
at a greater risk for developing the melanoma skin cancer themselves
Age: the risk for developing melanoma increases with age
Risk factors specific to non-melanoma skin cancers include:
- Exposure to Non-UV Radiation (ie. radiation therapy)
- Basal Cell Nevus Syndrome
- Chemical Exposure
- Permanent Skin Injury
- Actinic Keratosis
- Bowen’s Disease
Types of Skin Cancer
The types of skin cancers include:
Basal Cell Carcinoma: Ninety percent of all skin cancers in the United States are basal cell
carcinoma. This type of cancer grows slowly and rarely spreads to other
areas. Basal skin cancer can often be removed completely during a biopsy
with no further treatment required.
Squamous Cell Carcinoma: this common type of skin cancer has an extremely low fatality rate (less than 1%).
Melanoma: Melanoma skin cancer is less common than basal and squamous cell cancers,
but is more likely to spread throughout the body. Melanoma is the most
deadly type of skin cancer and if left unmonitored, it will spread to
the lymph nodes and to other sites within the body, making it very difficult
to contain and treat. Melanoma typically arises from pigmented (brown)
moles on the body and causes them to change shape and/or color.
It is important to check your moles regularly for any changes in shape/color
using the ABCDE’s of melanoma warning signs:
A—Asymmetry: the mole is not symmetric.
B—Borders: the borders of the mole are irregular.
C—Color: there is variation in the color within the mole.
D—Diameter: diameter is usually greater than ¼ inch
E—Evolution: changes within a mole.
If you suspect that you may have skin cancer, or are concerned about a
particular mole, it is always a good idea to see a physician for a skin
At your initial consultation, Dr. Gabbay will ask you questions about when
your irregular growths first appeared and how they have changed since
you first noticed them.
During your medical evaluation, Dr. Gabbay will look for the following
signs of skin cancer:
- A reddish or irritated patch of skin.
- A new, smooth skin bump (nodule) with a raised border and indented center.
- A raising or thickening of a previously flat mole.
- Scaling, erosion, oozing, bleeding, or crusting.
- Change in the surrounding skin tissue, such as redness, swelling, or small
new patches of color around a larger lesion (satellite pigmentations).
- Change in sensation, such as itching, tingling, or burning.
- A shiny area of tight-looking skin (especially on the face) that looks
like a scar with poorly defined edges.
- Change in skin consistency, such as softening or small pieces that break
off easily (friability).
- A persistent red bump on sun-exposed skin.
- A sore or an area of thickened skin on the lower lip
If Dr. Gabbay finds a suspicious or troublesome, he may perform a biopsy
to determine if the lesion is cancerous.
Just a few of the treatment options we offer include:
Simple Excision: the melanoma or non-melanoma skin cancer tumor is removed with a surgical knife.
Curettage with Electrodessication: the tumor is scraped off using an instrument called a curette. After
most of the tumor is scraped away, an electrode is used to kill any remaining
Cryosurgery: nitrogen or argon gas is applied to the cancerous tissue to freeze and
destroy it. Cryosurgery is
less invasive than conventional surgery and involves only a small incision for the insertion
of the cryoprobe through the skin. Typically, cryosurgery can be performed
using only local anesthesia, and because cryosurgical treatment can target
a limited area, the destruction of nearby healthy tissue can be avoided.
Laser Surgery: an intense, focused beam of light (laser) is used to destroy the skin
cancer tissue layer by layer
Immunotherapy: immunotherapy medications are injected into the skin to stimulate the
body’s immune response to destroy cancerous tissue
Dermabrasion: the removal of the top layer of skin using a rotating wheel or small
particles to exfoliate cancerous skin cells.
Radiation therapy: uses high-energy photons (X-rays) to destroy cancerous tissue. Radiation
therapy can be adjusted to treat superficial or deeply penetrating tumors
and may be performed in conjunction with chemotherapy for advanced tumors
Topical Therapy: used for skin cancer that is confined to only the top layers of the skin
Photodynamic Therapy: uses drugs that become active when exposed to light to eliminate cancerous cells
Mohs Surgery: Mohs Micrographic Surgery (MMS) is the most exact and precise method
of skin cancer removal. During this procedure, very thin individual layers
of cancerous tissue are removed one at a time until all cancerous tissue
has been removed. With Mohs surgery, cure rates are extremely high and
there is a low incidence of cancerous cell re-growth.
Skin cancer surgery can result in a loss of skin that is significant and
does not allow for the skin to simply be sutured back together. For this
reason, it is ideal to have a plastic surgeon reconstruct changes from
skin cancer surgery. Plastic surgeons are specialists trained in the art
and science of reconstructing changes to the body after disease, trauma,
or surgery. Dr. Gabbay has extensive experience and training in complex
reconstruction techniques after skin cancer surgery.
Specialized reconstruction after skin cancer surgery can help optimize
cosmetic and functional results. Often, after proper skin cancer reconstruction,
there are minimal obvious signs of prior surgery and patients are able
to resume normal daily life without a hint of their prior operation.
Techniques used by Dr. Gabbay for skin cancer reconstruction include:
Multi-layered skin closure: Closing multiple layers of skin helps reduce tension from a wound and
results in substantially less visible scarring
Skin grafts: for larger defects, the skin may be excised from one area of the body
and transplanted onto the affected area.
Skin flaps: Special techniques are used to transfer local skin into the area of skin
cancer removal using advanced geometry and planning. These local skin
flaps can transfer skin and tissue that is most similar to the tissue
taken as part of the skin cancer surgery and result in the most natural
Skin / muscle/ fascial flaps: Very large defects sometimes require the transfer of large amounts of
tissue from other parts of the body. Sometimes the muscle, skin or fascia
(deep supportive tissue under the skin) may be attached to its local blood
supply, and sometimes the transferred tissue must be removed from its
blood supply and re-implanted to the body using the surgical microscope.
Advanced Biological Technologies: (Integra, ACell Alloderm, etc.) There are a number of advanced biologically
based products that are used to aid many of the surgical techniques used
by Dr. Gabbay. These products have the advantage of allowing much less
invasive or aggressive surgery in many cases, or expediting the healing
or recovery phase.
Recovering from Your Procedure
Each patient’s recovery process will depend on the specific treatment
techniques that were utilized. Potential (although rare) skin cancer treatment
complications include: infection, excessive bleeding, wound dehiscence,
seromas, nerve dysfunction, hematoma and post-surgical scarring. If you
are concerned about post-surgical scarring, you can rest easy knowing
that Dr. Gabbay is a skillful
plastic surgeon who will incorporate specific techniques to minimize visible scarring
during your procedure, and he can also perform scar-reduction treatments
at a later date to further improve your skin’s appearance.
Call our team today at (310) 928-2558 to get started with a consultation.
Our Beverly Hills plastic surgeon is committed to helping you defend your health!