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FOREHEAD FLAP TECHNIQUE HELPING SKIN CANCER PATIENTS FACE THE WORLD AGAINA procedure performed at the University of Virginia Health System is helping patients face the public without the embarrassment of the scars left behind from the removal of skin cancer lesions on the nose. Dr. Stephen Park, associate professor of otolaryngology and the director of the division of facial plastic and reconstructive surgery, repairs the holes left behind from the surgical removal of skin cancer lesions from a patient's nose. Using the forehead-flap technique, Park is able to reconstruct a nose leaving it cancer free, fully functional and cosmetically accurate. "Essentially it involves bringing down a piece of the skin and muscle from the center of the forehead, rotating it 180 degrees to resurface the hole in the nose," Park said. "We leave it attached to the inside of the eyebrow and during this time the flap is providing a blood supply from the forehead." Once the forehead flap is in place Park pulls the two sides of the forehead together to close the area where the flap has been removed. "Since most skin cancer sufferers are elderly, the skin on the forehead has more laxity, enabling us to close the hole in the forehead with minimal difficulty," Park said. Once this is done the patient is sent home for three weeks with the pedicle - the flap of skin and muscle connecting the skin patch to the forehead - still intact. After three weeks the patient returns and has the pedicle removed. "During those three weeks the blood vessels have grown from the nose into the skin paddle of the flap, and so after about three weeks you no longer need the pedicle, which is why we divide it then," Park said. "It then takes a couple of months for the scars to heal fully and allow the flap to mature and settle down." Three months after the initial removal of the lesion the patient's nose is cancer free and shows no signs of the removal or reconstructive surgery. Park believes the forehead flap is second to none for skin cancer repair of the nose. "It is the gold standard, so in the end in terms of dependability, the cosmetic appearance and the function of the nose, it cannot be beat," he said. Park says, most importantly, once you have been diagnosed with skin cancer you have a high-risk of getting another cancer lesion. "It is essential that you have routine follow-ups, so finding and treating the next cancer, if and when it comes up, can be handled in a more simplistic fashion," Park said. A person who spends large amounts of time in the sun without protective sunscreen can be at high risk of skin cancer, especially on their face. Doctors diagnose skin cancer in approximately 1 million Americans each year. Fair-skinned people who live in areas that get a lot of sunshine are at greatest risk. But anyone can develop skin cancer, which is most commonly caused by overexposure to ultraviolet (UV) radiation from the sun. In fact, nearly half of all Americans will develop a cancerous skin lesion at least once by the age of 65. Tips for sun protection include:
February 11, 2003 |