The eyelid skin is the thinnest in the body and is often exposed to sunlight. As a result, it is often one of the first areas to show sign of aging and sun damage. Unfortunately, sun damage combined with genetics can lead to skin cancers of the eyelids, including at the lid margin.
Skin cancer of the eyelids is relatively common and several types exist. They rarely cause symptoms such as pain, itching or bleeding, so any unusual nodule or lesion that is growing should be evaluated. Bleeding and/or ulceration (skin breakdown) are strong indications of possible cancer but are seen in only a minority of cases. If in doubt, have the lesion checked out by Dr Dal Canto, which involves an examination and a possible biopsy.
Basal Cell Carcinoma
Basal cell tumors are the most common eyelid tumor. These skin cancers grow slowly over months to years, so often go unnoticed by patients. Basal cell tumors often grow as pearly nodules, potentially with a central depression. If left untreated, they can grow and infiltrate the surrounding tissue, eventually destroying it. Fortunately, they do not spread to distant areas throughout the body. They typically can be cured by full excision, followed by reconstruction of the defect created by the tumor removal.
Squamous Cell Carcinoma and Melanoma
These types of tumors are much less common than Basal cell tumors, but are more aggressive and require more involved care to ensure complete treatment. In addition to surgical removal, further testing may be needed to ensure the tumor has not spread anywhere else. This will be determined based on your examination and the biopsy results.
Removal and Reconstruction
Skin cancer needs to be removed surgically. Dr Dal Canto will often excise the tumor in the hospital operating rooms where a pathologist can immediately confirm that the entire lesion was removed. In certain cases, however, he will work in conjunction with a specialized dermatologist who uses a special technique known as Mohs surgery to remove the cancer. Dr. Dal Canto will then reconstruct the defect the following day.
Eyelid reconstruction may be necessary for a variety of reasons besides tumors and their excision. Defects in the eyelid can also arise from trauma or scarring from previous surgeries. Small defects can be directly sutured closed, even if they extend through the full thickness of the eyelid. Larger defects may require complex reconstructions, involving transfer of adjacent tissues (“flaps”) or skin grafts from other parts of the face or eyelids.
As a Board certified Ophthalmologist and a Fellow of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), Dr Dal Canto is uniquely trained and experienced in lid reconstruction. His goals are to attain an aesthetic as well as functional result in order to reestablish the eyelid for it’s primary role of protecting the eyeball.
Before and After Photographs
(WARNING: Some of the photographs are graphic in nature.)
Patient #1: Basal Cell Carcinoma: Reconstruction of Eyelid after Mohs Surgery Removal
Patient #2: Basal Cell Carcinoma: Reconstruction of Eyelids after Mohs Surgery Removal
Patient #3: Squamous Cell Carcinoma Excision and Repair
Patient #4: Basal Cell Carcinoma: Reconstruction with Mustarde cheek flap & upper eyelid skin flap after Mohs surgery resection