When Should Skin Cancer Be Removed by a Plastic Surgeon Instead of a GP?

Australia has one of the highest rates of skin cancer in the world. As a result, many Australians will need evaluation and treatment for suspicious skin lesions at some point in their lives. In many cases, a general practitioner (GP) can assess and remove certain skin cancers. However, there are situations where treatment by a specialist plastic surgeon may be recommended.

Understanding when a plastic surgeon may be involved in skin cancer treatment can help patients make informed decisions about their care.

The Role of GPs in Skin Cancer Treatment

General practitioners with training in skin cancer medicine commonly diagnose and treat many types of skin cancer. For lesions that are small, located in less complex areas of the body, and unlikely to affect surrounding structures, treatment by a GP may be appropriate.

GPs frequently perform procedures such as:

● Skin checks and dermatoscopic evaluation
● Biopsies of suspicious lesions
● Removal of certain basal cell or squamous cell carcinomas
● Monitoring of benign moles and skin changes

For many patients, this level of care is sufficient and effective.

However, some cases may require a more specialised surgical approach, particularly when the cancer is located in areas where cosmetic and functional outcomes are important.

Situations Where a Plastic Surgeon May Be Recommended

A plastic surgeon may become involved in skin cancer treatment when removal of the cancer is likely to require more complex reconstruction.

Common situations include:

Skin Cancer on the Face

Skin cancers frequently develop on sun-exposed areas such as the nose, eyelids, lips, ears, and cheeks. These areas contain delicate structures that influence breathing, vision, and facial expression.

Surgery in these locations may require careful planning to preserve both function and appearance.

Plastic surgeons are trained in reconstructive techniques designed to restore these structures after tumour removal.

Larger or More Complex Lesions

Some skin cancers grow larger before they are diagnosed or treated. Removing these lesions can leave a defect that may require advanced closure techniques.

Plastic surgeons often perform procedures such as:

● Local skin flaps
● Skin grafts
● Layered reconstructive closure

These techniques aim to repair the surgical site while maintaining normal skin movement and contour.

Recurrent Skin Cancer

If a skin cancer returns after previous treatment, the surgical approach may become more complex. Recurrent cancers can involve deeper tissue layers or require wider margins during removal.

Specialist surgeons may be involved in these cases to help manage the tumour and reconstruct the affected area.

Skin Cancer Near Important Structures

Skin cancers located close to structures such as the eyelids, nose, lips, or ears may require additional expertise to minimise disruption to these areas.

Surgery in these regions requires careful planning to ensure that vital functions such as blinking, breathing, or speaking are preserved.

Cases Requiring Reconstruction

In some cases, the primary removal of a skin cancer is performed by a dermatologist or other specialist, while the reconstruction is carried out by a plastic surgeon.

This collaborative approach is common when skin cancers occur in cosmetically sensitive areas.

What Does a Plastic Surgeon Contribute to Skin Cancer Care?

Plastic surgeons receive extensive training in both reconstructive and aesthetic surgical techniques. This training includes restoring form and function after trauma, cancer removal, and congenital conditions.

In skin cancer treatment, plastic surgeons focus on:

● Removing cancer while preserving healthy tissue where possible
● Reconstructing surgical defects
● Restoring facial symmetry and function
● Minimising tension on the surrounding skin

Each treatment plan is tailored to the patient’s anatomy, the location of the cancer, and the amount of tissue that must be removed.

Skin Cancer Treatment in Sydney

Sydney’s climate and high levels of sun exposure contribute to a significant number of skin cancer diagnoses each year. As awareness increases, many patients seek specialist advice when skin cancers occur on visible or complex areas of the body.

A/Prof Damian Marucci is a Specialist Plastic Surgeon in Sydney with extensive experience in reconstructive procedures, including surgery related to skin cancer removal. His training includes both local and international surgical experience, and his clinical practice involves reconstructive procedures designed to restore both form and function.

Patients referred for specialist care often require careful planning to ensure that the surgical approach addresses both the medical and reconstructive aspects of treatment.

When Should You Seek Specialist Advice?

Patients may consider seeking advice from a plastic surgeon if:

● A skin cancer is located on the face
● The lesion is large or growing
● Previous treatments have been unsuccessful
● The cancer is close to important structures such as the eyes or lips
● Reconstruction may be required after removal

A referral from a GP or dermatologist is commonly the first step in this process.

The Importance of Early Detection

Regardless of who performs the treatment, early detection remains one of the most important factors in skin cancer management.

Australians are encouraged to:

● Have regular skin checks
● Monitor moles and skin changes
● Seek medical advice for lesions that change in size, colour, or shape
● Protect their skin from sun exposure

Early diagnosis often leads to simpler treatment and improved outcomes.

Final Considerations

Skin cancer treatment often involves collaboration between healthcare professionals, including GPs, dermatologists, and plastic surgeons. While many skin cancers can be managed by a GP, more complex cases, particularly those involving the face or requiring reconstruction, may benefit from specialist surgical expertise.

Patients with concerns about suspicious skin lesions should consult their doctor for assessment and guidance regarding appropriate treatment options.