The eyelid skin is the thinnest skin on the body with significant long term exposure to sunlight. That makes the eyelids one of the most common locations on the body to develop benign and cancerous skin lesions. Luckily, most eyelid lesions are benign and easily treated by simple excision. The most common eyelid skin cancer types are basal cell carcinoma and squamous cell carcinoma. The symptoms could be a subtle bump, non-resolving "sty" or lesion, lash loss, or ulcerating non-healing nodule. presence of a nodule or lesion on the eyelid that grows, bleed or ulcerates should be evaluated. The diagnosis is made by examination and biopsy.
Basal cell carcinomas are the most common eyelid skin cancer. They grow slowly and steadily but don't metasisize. Squamous cell carcinomas are the second most common eyelid skin cancer and behave similarly to basal cell carcinomas but are usually more aggressive. Melanoma of the eyelid skin are very rare but have the same prognosis as other body melanomas and need to be treated aggressively.
Basal Cell Carcinoma
Basal cell tumors represent the ninety percent of eyelid tumors. These skin cancers grow slowly over months and years. They most often appear as a pearly nodule that eventually starts to break down and ulcerate. Despite being a cancer, these tumors don't spread to distant areas but rather just continue to grow and infiltrate the surrounding tissue. They typically can be cured by simple excision followed by reconstruction of the defect left behind after the tumor removal.
Squamous Cell Carcinoma and Melanoma
These types of tumors occur much less common but are more aggressive and require more involved care to ensure complete treatment. Again, primary treatment involves removing the tumor, but care must also be taken to ensure the tumor has not spread anywhere, causing larger health problems. Your surgeon will help coordinate this as part of your treatment depending on the size and circumstances of the tumor at presentation.
Treatment (Mohs Eyelid Reconstruction)
Eyelid cancers are usually slow growing, however because there is very little eyelid tissue to begin with, it is best to excise the lesion as soon as possible. It is often a two-step process, done in conjunction with a Mohs dermatologic surgeon who ensures that the entire tumor has been excised at a microscopic level. Mohs’ surgery is a procedure developed specifically to remove a cancerous skin lesion, using visualization under microscope to carefully remove the cancerous lesion layer by layer until all margins are free of any cancerous tissue. This technique spares as much of the surrounding healthy tissue as possible. Many of these eyelid defects can be sutured together directly, but many others may require more complex reconstructions. In many of these more complex cases, the surgeon will need to use transfer of adjacent tissues (what we call ”flaps”), or transfer of skin from other parts of the eyelid face or body (what we call “skin grafts”) to complete the reconstruction. Some of these more complex reconstructions may require more than one operation to complete (what we call “staged reconstruction”).
Who Should Perform Eyelid Skin Cancer Reconstruction Surgery?
An oculoplastic surgeon, who is a member of American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), is someone who is a board certified ophthalmologist who has completed additional 2-year fellowship training in cosmetic and reconstructive plastic surgery of the eyelids, orbits (eye socket), lacrimal system( tearing system) and surrounding structures. Dr. Taban is triple board certified by American Board of Cosmetic Surgery (ABCS), American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), and American Academy of Ophthalmology (AAO). Dr. Taban is an oculoplastic surgeon with expertise in eyelid skin cancer reconstruction surgery in Beverly Hills and Santa Barbara.
Before and After Eyelid Reconstruction
See more Before and After Eyelid Reconstruction Pictures.
Contact Dr. Taban
Dr. Mehryar (Ray) Taban is board certified in Ophthalmology and has extensive knowledge in the treatment of eyelid tumors. If you'd like to learn more about the various treatment options offered by Dr. Taban, contact his office today to schedule your initial consultation in Beverly Hills or Santa Barbara. To view additional images of Dr. Taban's patients who have undergone eyelid surgery, please visit our photo gallery.
Next, learn more about tearing.