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Skin Cancer Reconstruction

What are Eyelid Skin Cancers?

Skin cancers, including basal cell carcinoma, squamous cell carcinoma, and melanoma, affect one million Americans every year and it is estimated that half of all Americans will develop at least one skin cancer before age 65. Skin cancers can arise anywhere in the body but non-melanotic skin cancers (basal cell and squamous cell carcinoma) seem to have a predilection for the eyelids with 5-10% of all skin cancers occurring on the eyelid or around the eyes. The most common warning sign of skin cancer is a change in the appearance of the skin including a pigmented (dark) or non-pigmented (white) mass, ulceration, non-healing sore, redness or loss of eyelashes.

Other benign (non-cancerous) lesions commonly occur on the eyelid and may need to be biopsied or removed to examine the lesion for any evidence of cancer cells.

How are Skin Cancers of the Eyelid Typically Treated?

Ninety percent of skin cancers are curable if treated early in their course. Treatment of a skin cancer generally involves surgical excision of the tumor causing a “hole” or loss of tissue in that location.

Because the eyelids perform the critical function of protecting the eye, meticulous reconstruction is necessary to preserve the form and function of the lost tissue of the eyelid. Surgery may involve reconstructing several layers of the eyelid including the soft inner layer of the eyelid that touches the eye (conjunctiva), the firm connective tissue inside the eyelid (tarsus), and front of the eyelid (skin and muscle). Techniques that may be used to repair an eyelid defect include skin and muscle flaps, conjunctival grafts from an unaffected eyelid, or full-thickness skin grafts from behind the ear.

How Can I Avoid or be Screened for Skin Cancer?

Avoiding sun exposure is the best way to lower the risk for all types of skin cancer. Self-examination and evaluation by a physician are a good idea for people who are high risk and patients with a history of skin cancer should have regular checkups.

Prevention of skin cancer involves avoiding unprotected exposure to the sun using broad-brimmed hats, protective clothing, and using a UVA protective sunscreen of SPF 30 or higher.

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