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Plastic surgery

Within our plastic surgery practice, our Consultant Plastic Surgeon focuses on skin cancer and its early detection

Within our plastic surgery practice, our Consultant Plastic Surgeon focuses on skin cancer and its early detection.

He also offers a service for those with a cleft lip and/or palate, with his practice involving close collaboration with colleagues within dermatology.

Minor Skin Lesions

Many patients who visit us here at BMI St Edmunds request a ‘one-stop’ process to have a skin lesion removed. This could be because you have already been referred by your doctor or dermatologist with something that needs to be removed (such as a growth of the skin, e.g. a basal cell carcinoma).

Alternatively, there might be a lesion or mole, cyst or fatty lump that you don’t like the cosmetic effect of or that is a functional nuisance (such as a mole that catches when shaving or is unsightly). In this instance, you might prefer to only come along once to be seen and treated.

People with skin lesions, whether cancerous or non-cancerous, may visit BMI St Edmunds for a consultation. Some patients may want these lesions removed for cosmetic reasons, while others will be worried about skin cancer.

The reason why Plastic Surgeons get involved with skin cancer treatment is that, in order to remove something with a decent margin of clear tissue, the resulting defect is often too big to draw together with stitches. Plastic Surgeons may use a variety of procedures to get the best result, this may involve:

Plastic surgeons may use a variety of procedures to get the best result, this may involve:

  • Re-arranging tissue ‘flaps’
  • Skin grafts, which involves taking a patch of skin from another part of the body, which could be a whole piece of skin from the collar bone for the face, or a shave of skin from the arm or leg, which heals like a bad graze after about 10 days.

Removal of Skin Cancers

Removing skin cancers from awkward sites can mean complex reconstruction work.

For patients with a suspicious-looking mole on their face or body, the primary concern is for evidence of a malignant melanoma, says our Consultant Plastic Surgeon here at BMI St Edmunds Hospital.

If there is a new mole on the patient’s body or face – or if an existing mole has changed shape, size or colour – it will need to be assessed here in our practice. The areas of the body which are most affected are the back in men and the legs in women, with melanoma not often seen in areas that are protected from sun exposure.

There are two other types of skin cancer seen within our clinic. These are:

  • Basal cell carcinoma, which can be treated and cause minimal damage if found and treated early.
  • Squamous cell carcinoma, which can appear as thick, scaly patches on the skin. These patches may form a crust, or bleed. They might also look like warts. This type of cancer can usually be treated with minor surgery.

Currently, the patient is seen here by our Consultant Plastic Surgeon, before returning for treatment – if required.

Our Consultant will take a full medical history and ask you if you have any allergies.

He will also ask you about your symptoms and will examine you, taking photographs, if necessary, for your medical record. 

If you are keen to have a skin lesion removed, our Consultant Plastic Surgeon can explain specifically his advice about how a lesion can be removed and his view of the method which will give the best result.

The removal of any lesion involves a local anaesthetic, which means you are going to be awake, but the area will be numb, so that you feel no pain.

Before going ahead, our healthcare team here at the hospital will check to make sure you are having the operation you came in for and will ask you about any medicines that you are on which might affect surgery (such as blood thinners).

A special ink is used to mark out the piece of skin to be removed or the site of the lesion beneath the skin (e.g. a mole, cyst or a lipoma). If removing a growth, such as a basal cell carcinoma, a margin of apparently normal skin has to be taken as well, to reduce the risk of it growing back.

Next, an area in and around the lesion and whatever nearby tissue is required for reconstruction, will be numbed with a local anaesthetic injection. This takes a few minutes to work.

An antiseptic solution will then be used to clean the area.

Some nuisance value keratoses or some pale moles around the face can be shaved flat.

When a hole is required to remove the whole lesion and the skin within which it sits, it can be repaired by:

  • Simple Direct Closure – The commonest way to close the hole if it is small is to create an ellipse shape, such that the surrounding skin can be gently pulled together with stitches. This will leave a straight-line scar. Some of these stitches may be dissolvable but, often, stitches on the skin need removal after a week.
  • Rearranging local tissue – a ‘flap’. If there is not enough loose skin next to the hole to allow the edges to be stitched directly, a neighbouring area of skin can often be partly lifted and moved round to fill in the hole. This ‘flap’ is then stitched into place.

Importing Extra Tissue – If a large area of skin has been removed, it may be necessary to repair the wound with a piece of skin taken from elsewhere. Such a ‘graft’ is often taken from behind the ear or just above the collarbone. These sites are chosen because they already have an excess of skin and the colour matches reasonably well with the area it is going to. The graft is then laid over the area where the facial lesion has been removed and sewn into place. A dressing pressing on the graft to keep it still is put over the graft for around seven days. The tip of the nose is a site where sometimes there is not enough skin to close or rearrange nearby skin with a flap, so a skin graft might need to be employed.

How long does the procedure take?

The amount of time that the removal takes obviously varies depending on the size of the area involved.

What about after the procedure?

You will require dressings for about a week.

In future, we plan to offer a ‘one-stop shop’ treatment slot, so patients can attend clinic for a consultation and decide – after some consideration – to have their skin lesion removed the very same day.

Here are some more reasons why you might choose BMI St Edmunds for your plastic surgery consultation:

  • Reduced waiting times – Patients who visit BMI St Edmunds Hospital can, of course, benefit from shorter waiting times for plastic surgery appointments.
  • Flexible appointments at a time to suit you – You can choose an appointment time to suit you and your schedule – and in some cases, remote consultations may be offered.
  • Consultant-led appointments – Your appointment at BMI St Edmunds will always be Consultant-led, and you’ll see the same person every time you visit.
  • A multidisciplinary approach – Our team are experts in skin cancer management, in collaboration with colleagues and dermatology.
  • Patient satisfaction and personalised care – In an independent survey* in 2020, 99 of our patients said they would recommend BMI St Edmunds Hospital, and the hospital has a CQC overall rating of ‘Good’. *Results compiled by Quality Health.         

For plastic surgery consultations, patients travel from in and around Bury St Edmunds itself, as well as from Ipswich, Norwich and Cambridge.

Want to book a consultation with our Consultant Plastic Surgeon at BMI St Edmunds Hospital? Book an appointment via our handy online booking system.

Specialists offering Plastic surgery

Mr Saif Azzawi

Consultant Plastic Surgeon

FRCS (Plast), MB Ch.B (Hons.), MRCS (Eng)

St Edmunds Hospital

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