Reconstructive Facial Surgery
Traumatic accidents, cancer treatments, and certain congenital conditions can all cause serious facial injuries or defects. Reconstructive facial surgery, a crucial application of modern plastic surgery techniques, helps to reconstruct both faces and lives. Dr. Hillstrom is fully trained and qualified in the field of reconstructive plastic surgery and is prepared to help with even the most serious cases of birth defect or accident trauma.

Personal Facial Reconstruction Consultation
During a personal reconstructive surgery consultation with Dr.Hillstrom, he will examine the area of your face in need of reconstruction to determine the best techniques for treatment. Further testing, such as CT scans, may be necessary before the final plan can be made. Dr. Hillstrom will create a treatment plan and illustrate the possible postoperative outcome to help you make decisions about your reconstructive surgery.

The Facial Reconstruction Procedure
Techniques and types of surgery vary depending on the area treated and degree of facial reconstruction needed. Dr. Hillstrom strives to keep up with new advancements in facial reconstruction for his patients. With his training and experience in reconstructive surgery, Dr. Hillstrom can reconstruct even large disfiguring facial defects so that they are almost undetectable to the untrained eye.

Skin Cancer Removal
Skin cancers are among the most common cancers afflicting mankind and there are a variety of risk factors including environmental exposures, genetic predisposition, radiation exposure and immunosuppression. Skin cancers can be broadly divided into melanoma and non-melanoma skin cancers (basal cell carcinoma and squamous cell carcinoma. In addition, skin appendage cancers (arising from sweat glands, hair follicles and sebaceous glands) may involve the skin. Any individual with a lesion that does not go away or changes or that is at all suspicious should be evaluated and possibly biopsies.

Basal Cell Carcinoma (BCCA)
Basal cell carcinoma is the most common type of skin cancer. In general these skin cancers occur in sun exposed areas and more than three-fourths are discovered in the head and neck region. These cancers are generally slow growing and rarely metastasize (spread). Sun exposure particularly during childhood and adolescence is the greatest risk factor. Other risk factors include ionizing radiation, immunosuppression and certain genetic syndromes.

Squamous Cell Carcinoma (SCCA)
Although less common then BCCA, SCCA is generally considered more serious. These tumors have a greater likelihood of spreading to other parts of the body (metastasizing). The incidence of SCCA has increased over the last decade. Like BCCA risk factors for SCCA include sun exposure, ionizing radiation, immunosuppression, certain viruses (human papilloma virus), genetics and chronic skin disorders (burns, sinus tracts, venous stasis wounds).

Premalignant Lesions
Premalignant lesions are skin lesions that have the potential of becoming malignant and include actinic keratosis, Bowen's disease, leukoplakia, erythroplakia, keratoacanthoma as well as radiation dermatitis. These lesions can be difficult to distinguish by appearance alone from invasive skin cancers.

Melanoma
Malignant melanomas are arguably the most lethal of the skin cancers, and may arise de novo or from a pre-existing "mole". Melanomas are usually but not always pigmented and can be difficult to distinguish from moles. Irregular borders, change in color or size, ulceration, and bleeding are all signs suggesting possible melanoma. These cancers have a relatively high potential to metastasize, and the prognosis is related to depth of invasion.

Diagnosis of Skin Cancers
The definitive diagnosis of skin cancer is by a biopsy and pathologic examination of the lesion under a microscope. Biopsy may be incisional where only a part of the lesion is surgically removed or excisional where the entire lesion is removed. Punch biopsy and shave biopsies may also be performed for some skin abnormalities suspicious for skin cancer. Shave biopsy should be avoided in melanoma.

Treatment
The treatment of skin cancers is dependent on many factors. For most skin cancers surgical excision is probably the best for of treatment because it allows the diagnosis to be established as well as determining the status of the margins. Other forms of therapy including freezing the lesion (cryotherapy), cauterization, laser vaporization and topical chemical agents. Often premalignant appearing lesions such as actinic keratosis is treated with these later nonsurgical methods.

Frozen section
Frozen section is a technique where the margins can be frozen and examined at the time of the surgery to help to determine if the margins are clear. This technique is not perfect, but can be helpful in cases where the margins are hard to determine by observation alone. In addition, in larger sized lesions where local or regional tissue is to be used to reconstruct the defect frozen sections can be helpful.

Recovery Following Facial Reconstruction
Recovery varies greatly depending on the area treated and the amount of reconstructive surgery performed. Swelling and bruising are common following surgery and typically heal within two weeks. Sutures are generally removed five to seven days after the surgery. Any scars that result from the procedure will become less noticeable over time.

Facial Reconstruction Results
Results of facial reconstruction vary depending on the type and extent of reconstruction performed. Improved appearance is typically noticeable immediately following surgery and results last a lifetime.

Contact Us for Facial Reconstruction and Reconstructive Surgery Procedures
If you are interested in facial reconstruction and other reconstructive surgery, contact Hillstrom Facial Plastic Surgery, conveniently located in Sarasota, Florida.