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Nasal Reconstruction (rebuilding the nose after skin cancer)

Explore nasal reconstruction after malignant melanoma skin cancer, nasal surgery, & sculpture of the nose by Dr. Michael Bermant, MD plastic & cosmetic surgery. Full thickness skin graft was used for reconstruction.

Michael Bermant, MD
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Malignant Melanoma

Full Thickness Skin Graft Reconstruction

 

Malignant Melanoma of Nose
Full Thickness Skin Graft

Skin Cancer

 After Surgery
malignant melanoma recurrent of nose - Michael Bermant, MD plastic cosmetic and reconstructive surgery
magnified view malignant melanoma recurrent of nose - Michael Bermant, MD plastic cosmetic and reconstructive surgery

This patient had a lesion excised by another surgeon. This recurrent lesion upon biopsy by me was found to be a malignant melanoma. Retrospective pathology found that the first lesion was a malignant melanoma. Sometimes it is difficult to determine the nature of a pigmented lesion.

 

Malignant Melanoma of Nose
Full Thickness Skin Graft

Skin Cancer

 After Surgery
full thickness skin graft malignant melanoma recurrent of nose - Michael Bermant, MD plastic cosmetic and reconstructive surgery
full thickness skin graft  year later malignant melanoma recurrent of nose - Michael Bermant, MD plastic cosmetic and reconstructive surgery

The patient had a wide excision of the recurrent site and a full thickness skin graft from the neck. The early result (2 months) still shows a contour irregularity. The photograph on the right is from a year later, showing how the contour improved. Neck skin approximates facial skin in color and texture.

A full thickness skin graft is closer to the depth of normal skin than a split thickness skin graft. Both are thinner. Flap reconstruction from the forehead is another option. The thicker flap reconstruction would also hide a local recurrence. This melanoma is already recurrent and the skin graft permits better observation.

This excision and graft reconstruction was done under local anesthesia as an out patient. Some melanomas need more extensive surgery sampling the lymph nodes. The location of this tumor puts both parotid glands and neck on both sides at risk for the tumor to pass through. Your surgeon and oncologists will present the various options for treatment. If lymph node dissection is recommended, general anesthesia and a hospital stay are likely.

Certain clinical conditions are important to help with the decision.

  • Ulceration of the melanoma
  • Lymph node lumps or masses
  • Intermediate thickness tumors


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