Skin is the largest organ in the human body. It is our outer protective barrier, and as such the skin gets exposed to all of the elements. Over time damage from the sun, environmental exposures, and even just the normal cellular turnover process can lead to skin cancers. Whether due to exposure, genetics, or just bad luck, these skin cancers need to be removed with a margin of safety. Our surgeons have vast experience in reconstructing cancer defects from head to toe, and everywhere in between.
Our surgeons work with many of the area’s best dermatologists in diagnosing and managing skin cancers. Oftentimes concerning lesions are first biopsied by a patient’s dermatologist or primary care physician, and then referred for removal and reconstruction. This can take place in the office under local anesthesia, or the operating room with further sedation for larger and more complex lesions. When skin cancers are located in areas where the remaining skin is precious (eyelids, lips, nose), your surgeon may coordinate with a special dermatologist, a Mohs surgeon, to ensure precise removal and clearance of cancer before construction.
Our surgeons help treat all forms of skin cancer including basal cell, squamous cell, and malignant melanomas. Reconstruction blends oncologic (cancer) and aesthetic concerns, working to obtain the most functional and cosmetically concealed closure as possible. A variety of techniques are utilized, including complex closures, local or regional tissue flaps, or skin grafts as necessary. Postoperative scar care will be discussed to optimize your recovery.
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At your first consultation visit in Chesterfield, MO, your surgeon will review the pathology report with you and examine the area of concern. Using an erasable marker, they will draw the margins of normal skin that need to be removed as well as the planned closure directly on your skin. They will discuss all applicable reconstructive options to help you get the best outcome possible. Photos will be obtained and you will be scheduled for your excision and/or reconstruction either in the office or operating room depending on your desires and reconstructive complexity. Dissolvable sutures that do not need to be removed are typically used for most cancer reconstructions. Skin grafts may require special splints and care that your surgeon will discuss with you.
Smaller cancers that are removed and closed in the office typically have minimal downtime of only 1-3 days. Larger areas may be sore for a few days, but most often Tylenol or a mild narcotic such as Tramadol is all that is needed to remain comfortable in your recovery. You will want to avoid heavy lifting or straining for a few days before returning to more normal activities. Often patients can shower the next day.
He did a great job
“My experience with Dr. Hulsen was a very comfortable visit. He took a lot of time with me explaining the procedure he was going to perform which was the removal of skin cancer. He did a great job and I have full confidence in him as a great Doctor!”
