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Eyelid & Facial Skin Cancers at Doctor & Associates serving Fairfield County Norwalk Wilton Westport Connecticut

About Eyelid and Facial Skin Cancers
Growths on or around the eyelids and face are common. The vast majority of these lesions is benign and can be easily removed in the office with excellent results and little if any discomfort. The approach to growths on the eyelids and face is similar to elsewhere on the body in that changes in appearance, size or color are all considered important to bring to the attention of your doctor who will then carefully evaluate these eyelid and facial growths. Sometimes a quick and relatively simple in office biopsy procedure may be required to determine whether the lesion is problematic. Should the growth in question be malignant, we can remove it and provide the necessary level of treatment or surgery to create a proper cosmetic result. There are several types of malignant growths of the eyelid and face that we want to observe and identify.

Basal Cell Carcinoma
By far, the most common malignant or cancerous growth of the eyelid is known as basal cell carcinoma. This is most typically a very slow growing malignancy that may be present for several months before it is recognized. This cancer rarely spreads to other parts of the body, but it does require removal and reconstruction. We will perform an evaluation of any abnormal growth of the face and eyelids and will possibly recommend an in office biopsy. Should the biopsy specimen be read by the pathologist as positive for malignancy, further management will be required. This may include a simple office procedure or may require extensive removal and reconstruction in a hospital setting under monitored anesthesia. If this is done in the hospital, frozen sections will be taken of the margins of the lesion. These specimens will be sent to the pathologist while we await the report. An alterative is excision with Mohs micrographic surgery performed by a dermatologist. In either case, when all abnormal tissue has been removed, we will reconstruct the affected area. This may require simple closure with sutures, or it may require the use of skin grafts or flaps. As a reconstructive and cosmetic facial plastic eye surgeon, I have considerable experience in repairing defects from the smallest to very extensive reconstruction if needed. Once the tumor is removed completely, the patient is generally kept under observation yearly over the next several years. When treated properly, it is very unlikely that the tumor will recur or cause further problems, but once you have a single basal cell, it is certainly more likely to have others in the coming years. Generally, patients do extremely well and most patients who undergo resection and reconstruction of a basal cell carcinoma can have no residual cosmetic deformity.

Squamous Cell Carcinoma
Like basal cell carcinoma, this is a relatively slow growing cancer. It does however, have a greater potential to locally invade, as well as metastasize. It can also travel along nerve roots and therefore, can often present with pain. Fortunately, it is much less common than basal cell cancers. It is managed in the same way as a basal cell cancer, although a wide excision may be required. It is also generally dealt with more promptly than a basal cell cancer.

Sebaceous Cell Adenocarcinoma
Sebaceous cell adenocarcinoma is exceedingly rare, but it is most specific to the eyelids. It can clinically mimic several other benign problems of the eye and it is therefore frequently misdiagnosed or diagnosed after delay. It most frequently occurs in patients in the 70’s and 80’s but can occur at any age. It is serious in the sense that it has metastatic potential. Diagnosis is often difficult even when an adequate specimen is obtained and sent for pathologic evaluation. Again, as a reconstructive and cosmetic facial plastic eye surgeon I have extensive experience in diagnosing, managing and treating patients with sebaceous cell adenocarcinoma.

Like other parts of the body, an abnormal coloration to the skin can represent a melanoma or something along the spectrum of a melanoma. While eyelid/facial melanomas are rare, any pigmented lesion around the eyelid deserves attention. Similar guidelines to pigmented lesions or moles on other parts of the body, certainly apply to the eyelids. Changes in color, size and behavior all warrant evaluation and possible biopsy.

If you or someone you know would like to learn more about eyelid and facial skin cancers, please call Doctor & Associates at 203-227-4113 to schedule a consultation and evaluation.

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