Eyelid skin cancer is a very common skin cancer that we see in Australia. Approximately 5-10% of all skin cancers occur in the eyelid
The most common type of skin cancer is Basal Cell Carcinoma (BCC), followed by squamous cell carcinoma, sebaceous cell carcinoma and melanoma.
Eyelid skin cancer can present in more than many ways and early skin cancers can be very subtle. Unlike other parts of the face where skin cancer has typical appearances, in the eyelid they present in many atypical ways as well. Hence it is important to confirm the diagnosis of each and every lesion on the eyelid. Eyelid cancer can present in the following ways a small lump, a bleeding ulcer, a small red patch, loss of eyelashes, minor skin changes and scarring of the skin, swelling of the skin, thickening of the skin.
A biopsy is the best way to confirm the diagnosis of a skin cancer.
Don’t delay your treatment. The quicker you remove an eyelid cancer the smaller the defect that needs to be reconstructed. With a smaller defect to reconstruct, the treatment is successful, and the function and aesthetics of the eyelid can be maintained.
The eyelid is probably the only facial structure that has to function perfectly after reconstruction. In addition, since the eyes are the focus of the face the reconstruction should be aesthetically pleasing to allow the patient to socially integrate back into the community easily.
The main reason for recurrence is incomplete removal of the tumour. So, it is important to get it right at the start by an experienced Plastic Surgeon.
We have a pathologist attend the operation and microscopically analyse the tumour once it is removed. Only when the pathologist says it is all clear, we proceed with the reconstruction. This way we can ensure that the cancer has been completely removed and nothing has been left behind. This is not only reassuring to the patient but also to the surgeon.
There are numerous plastic surgery techniques that can give excellent results and restore the function and aesthetics of the eyelid. Various forms of flap reconstructions, canthoplasty, canthopexy and skin grafts are used.
The eyelid reconstruction surgery can take 1.5 to 2 hours depending on the complexity. The surgery is performed in a hospital under anaesthetic for your safety and comfort.
Most eyelid reconstructions are done as Day Surgery cases. Occasionally complex eyelid reconstruction may require additional hospital stay.
Your formal pathology report will confirm the type of cancer, has it been completely removed, is there spread into the nerves or lymphatics or are there any other suspicious findings.
If the cancer has been inadequately removed, you will need additional surgery. If the cancer shows signs of spread to the nerves and lymphatics you may need radiation therapy, for which you will be referred on to a specialist radiation cancer specialist.
Typically, the healing process can take up to two weeks. It is important that you follow all the post-operative instructions. You may get the wound wet after 1-2 weeks but going under water is not advisable for 4 weeks.
Scars on the eyelid heal very well. It is normal for the scar to be visible for the first 3-6 months it will continue to fade and by 12-18 months you can expect good resolution of the scars. If appropriate scar treatment using silicone gel is recommended.
All surgery carries risk. A second opinion from an appropriately qualified health practitioner is recommended before proceeding