Richard has extensive experience in all aspects of complex skin cancer surgery, including revisional surgery and management of cancer recurrence. He has developed strong links with Medical and Radiation Oncologists, should these treatments be recommended. In addition, Richard is a member of multiple multidisciplinary skin cancer teams and tertiary institutions, where complex treatment plans can be initiated and monitored.
Many skin cancer cases can be managed as day cases in hospital, often without general anaesthesia. However, more complex cases may require pre-operative imaging, diagnostic testing and multi-day admission. As such, each patient is treated as an individual, with treatments recommendations based on current international best practice and up-to-date evidence.
What can I expect?
At your initial consultation, Richard will take a routine history and targeted examination. Any diagnostic test results will be interpreted, and sometimes further tests need to be ordered to enable a complete understanding of your current risks and inform your personalised treatment plan. If further tissue samples are required for diagnosis prior to surgery, these may be taken under local anaesthetic in the rooms. Most often, we endeavour for these to be taken on the same day as your consultation, but occasionally this needs to be at a separate time. These biopsies form an integral part of accurate surgical planning, and help you make an informed decision about your care. Please keep in mind that it is exceedingly uncommon for the definitive excision of a skin cancer to be undertaken during or immediately after your initial consultation.
What happens after surgery?
Richard will provide your with post-operative instructions about activity, dressings and answers to common questions, plus provide your initial follow-up appointment date. Depending on the procedure, we usually schedule this between 3-7 days after surgery. This is often with our highly qualified nursing staff. Richard routinely sees all post-operative patients at around six weeks after surgery, with additional reviews as needed. You will have a chance to discuss your outcome and any future follow-up surveillance.
Possible complications:
The decision to undergo skin cancer surgery should only be made after considering if the potential benefits can achieve your aims, and whether the risks are acceptable to you. The possible risks/ complications of thigh lift include (but are not limited to):
- Cardiac problems, including heart attack or arrythmias.
- Venous thromboembolism (including deep vein thrombosis and pulmonary embolism, which may be fatal).
- Surgical site infection.
- Haematoma/ seroma requiring return to theatre.
- Wound breakdown, delayed healing or protruding sutures. This may take a considerable time to settle.
- Conspicuous scars, including hypertrophic, stretched or migrated scars.
- Possible need for revisional surgery. Richard will only consider revising your skin cancer reconstructive surgery if he believes:
- there is a definable structural issue,
- this issue is realistically able to be improved with surgery and
- the risk of revisional surgery causing a worse result are minimal.
- Contour asymmetry.
- Nerve injury.
- Incomplete excision of tumour.
- Failed reconstruction including skin grafts or local flap reconstructions.
- Donor site wound breakdown, infection or delayed healing.
- Cancer recurrence, local, regional or systemic metastasis (spread).
- Definitive excision returning a different result to pre-operative biopsy or clinical diagnosis. This may necessitate additional or different treatment.