Basal cell carcinoma surgery with or without a flap?

Hello, I have an infiltrative, invasive badal cell carcinoma in the upper lip reaching into the vermillion. I know that all depends on the size of bcc, which will be detected during the surgery. I know that some surgeons remove this without flaps and some prefer flaps. That was my experience when consulting my case with 3 surgeons. The one I chose proposed 1 or 2 flaps in my case. One for vermillion to cover the defect after cutting. The flap shall come from the right side from the lower lip. The other flap from nosolabilal fold. I chose this clinic, because they make microscopic controlled surgery and proposed twighlight sleep. I am wondering what is the reason, that some say we will just cut and sew it and others suggest a complicated reconstruction. I am afraid how I will look after the surgery, that there  will be defects and scars.

  • Hi EvaM

    Thanks for getting in touch. It sounds like you have researched your treatment and been very thorough when deciding on a surgeon and procedure.

    The aim of surgery is of course to remove the cancer and get good clear margins but it’s also to give you the best aesthetic outcome. Sometimes an excision and stitch procedure can be a good option based on position and size of the skin cancer.  Micrographic surgery may be recommended if the cancer is on the face or in a position where there is not much surrounding skin to cover.

    The guidance on management of basal cell skin cancers is currently being updated but it might be worth reading the previous guidance from 2008.  

    You will have made the correct decision for you based on all of the information you have been given. Your surgeon will be aiming to give you the best aesthetic outcome and get rid of the cancer.

    Remember that it will take time to heal and for the area to settle after surgery. Your team will give you clear instructions on caring for your wound and what to look out for during your recovery.

    If you think it would help then think about giving us a call on the support line and we can talk things through further.

    Best wishes, 

    Fiona (Macmillan Cancer Information Nurse).