29 July 2021
This is a common area for skin cancers and needs to be excised (removed) adequately and the post-excisional defect well repaired, to leave the patient with good form (appearance) and function.
During excision, the underlying muscle and vestibular mucosa (the inner lining of the lip) is also removed to achieve a good result.
However, in Mr JG, a 56 year old man, who was a regular smoker, the lesion on his lower lip was very extensive.
Cancer marked out with usual resection margins (Figure 1)
The standard treatment would have involved extensive resection (removal) of muscle and mucosa.
This is possible and often gives a good outcome, as seen in Miss KW, a 55 year old lady with an extensive skin cancer involving the upper lip and cheek:
Figure 2 – Before Surgery
Figure 3 – During Surgery
Figure 4 – During Surgery
Figure 5 – Four years later
Figure 6 – Four years later
In Mr JG, as the lesion was much larger, it was decided to treat the problem with a different approach.
The tumour was excised including mucosa and all submucosal tissue, down to the muscle layer.
At surgery, it was clear the tumour was still in the deeper mucosa (deep papillary dermal layer) and had not gone to the muscle layer.
The large mucosal defect was repaired by extensive mobilisation of the vestibular mucosa (the inner lining of the lower lip) while the muscle layer was preserved.
The pathology report confirmed complete removal of tumour.
Figure 7 – After surgery
Figure 8 – After surgery
Figure 9 – After surgery
Figure 10
Figure 11
Skin cancers of the face are difficult to treat – early treatment is best but if the problem is extensive, an expert Plastic Surgeon often helps in achieving a good outcome.
About The Author - Dr Chandran Arianayagam
Dr Chandran Arianayagam is an internationally trained Specialist Plastic Surgeon. Based in Coffs Harbour since January 1995, he has trained and worked in India, Malaysia, the United Kingdom, United States and Australia. He brings 30 years of experience and expertise to the Mid-North Coast region.
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