Devastating facial skin cancer surgery offers miraculous results

 

[caption id="attachment_20734" align="alignleft" width="300"] Before and after paramedian flap surgery[/caption]

Carol Forsloff----Skin cancer can have devastating consequences, from malignant melanoma that can cause death to disfigurement.  But modern medicine often restores the worst of conditions, as demonstrated by a recent case of skin cancer that spread to encompass much of the face, demonstrating the surgeon’s brilliance and the wonder and value of good care.

It is that kind of care that one would wish for skin cancer surgery, much of which just involves incision of a small sore somewhere.   In some cases, however, skin cancer can be so virulent and destructive of tissue, even if it appears small, that it can create pain and problems for many.

One of the more difficult facial reconstructive surgeries is the paramedian forehead flap.  This type of surgery is actually done to reconstruct the problems caused by skin cancer on the nose, especially the kind that is growing and occupies a prominent selection in the nasal area.

The surgery uses skin from the forehead over the eyebrow.  It is then moved vertically and used to replace nasal tissue from the incision where the cancer has been removed.  The technique is actually hundreds of years old, yet it has been modified and perfected over the years by many doctors and is now a popular way of repairing nose defects.  It is considered the most thorough type of surgery for that type of defect, although it requires a lengthy recovery and scarring of the forehead and the nose.  It also causes considerable facial bleeding for many people and the need to be sedentary for some time.

Each case is different, but each also has the subsequent value of having a greater likelihood that the look of the nose will match the skin tones of the rest of the face.

Often with older people, the surgeon may use another section of the face to repair the nose, because of the pain and disability caused by this more comprehensive approach using the medial flap.  However, with sufficient instruction in care, the senior can cope and get through the operation and its aftermath.

Recovery can take a few months, and even longer for the scars to heal.  The best follow up treatment involves massage, rest and proper skin care.  The result can be exceptional with a talented surgeon, a hopeful attitude and that quality aftercare.

For those who fear the worst, it is potentially going to be that “best outcome” for nose surgery.  But the best prevention, to avoid that surgery, are hats and sunscreens, something older folks did not know many years ago, but is said repeatedly in advertisements and articles, that good advice that can stop someone from having skin cancer surgery at all.

 

Facial reconstruction makes miracle for Oregon woman

[caption id="attachment_11316" align="alignleft" width="300" caption="Facial reconstruction preparation - wikimedia commons"][/caption]

 PORTLAND, OREGON - Carol Forsloff - In Oregon a team of doctors has provided a young woman a new life after her face had been virtually destroyed 10 years ago and now reconstructed by facial prostheses.

In Oregon a medical team added the final touches for a prosthesis for a

young woman's face.  They used a wax model of what Chrissy Stelz had
looked like 10 years ago in order to get an appropriate resemblance.

Steltz was 16 when an accident with 12-gauge shotgun left her blinded, her nose, part of
her right eye and her left eye, eye lid and eye muscles destroyed.  For
years she wore a sleep mask to cover up the scars and damage.


She was quoted in a recent edition of the American Medical Association
online magazine as saying she wanted the prosthesis being made to reconstruct her face to appear more normal in public and to her
1-year-old son.

"He's at an age where he will grow up knowing me with my face, like everybody else," Steltz said.  This type of prosthesis is considered rare, because multiple facial features have to be reconstructed.  Larry Over, DMD, MSD, a maxillofacial prosthodontist in Eugene, Ore., guided the construction of the facial prosthesis made.

It took ten years for Steltz to get treatment because of health insurance problems and her pregnancy.  Steltz was reported by the magazine to use the prosthesis for daily wear.  She talks about it this way,"I feel very lovely. I feel like a regular person again," she said. "I feel like now when I talk about this, people will listen. Before, when I was wearing the sleep shade, I didn't feel like they were really listening. I felt like they just felt sorry for me and weren't really listening to what I was saying."

Experts say the prosthesis will last three years, and the mold can subsequently used to
make others.  Aging is also done through working with the basic shapes
of the mold before the prosthesis is made.

Making facial prosthetics must be done artfully, according to the experts.
Ann Vitale is a maxillofacial prosthetics technician.  She said when
she first started she met a young girl who had severe facial damage, but
could see the rewards for doing something about it  “Right then, I knew
this was going to be a challenging job,” says Vitale, “You really help
to give people their lives back, she was reported as saying for an
educational online article.

For 22 years, W. Donald Gay, DDS, associate professor of otolaryngology, and Vitale have
worked together to help to rebuild  faces of patients ranging from 3 to
80 years old.

“We take kids who don’t feel normal, and we help them become normal,” says Gay, a
maxillofacial prosthodontist. “And we help adults who can’t be normal
adults—they can’t work or socialize—and we make it possible for them to
resume those activities.”

The team explains how four years ago surgeons took 13 hours to remove a
rare cancer on Jean Cohen's left eye by removing the eye and part of her
sinuses.  This left a deep cavity in her face.

“I wasn’t concerned about dying or having cancer,” says Cohen, a
70-year-old retired surgical head nurse from Creve Coeur MO. “I was
concerned about how my grandchildren would view me.”

Artfully done prosthetics are said to do the trick in restoring the person's appearance.

The American Academy of Facial Plastic Surgery and Reconstruction is the medical organization
that outlines the procedures and techniques used in rebuilding faces.
Rebuilding or reconstructing faces requires special skill and training
and a set of ethics that asks doctors to make sure surgery is done for
all the right reasons and in the right ways.

To help a young mother regain her life is likely that good reason, and her delight with
the result indicates it was also done the right way.