Dr Axel De LangePlastic Surgeon
A consultation room at the clinic, with a treatment chair beside a curtained window

Skin Cancer Treatment

Skin Cancer Treatment in Brussels · Dr Axel De Lange

Skin cancer surgery combines rigorous oncological care with reconstructive techniques that restore the appearance and function of the treated area.

Skin cancer surgery involves removing a cancerous skin lesion with safety margins adapted to its nature, its location and its degree of aggressiveness.

The main skin cancers are basal cell carcinoma, squamous cell carcinoma and melanoma. They behave differently at a biological level and require specific treatment strategies.

Basal cell carcinoma is the most common and carries an exceptionally low risk of spreading, whereas squamous cell carcinoma and, above all, melanoma may require more extensive oncological management.

The procedure relies on precise excision of the lesion, followed by histopathological analysis to confirm its nature and check the excision margins. When the tissue defect is large or located in a delicate anatomical area, surgical reconstruction is carried out to preserve function and appearance as well as possible.

The goalTo achieve complete oncological excision while preserving essential anatomical structures and seeking the best possible functional and aesthetic result.

Surgery is intended for patients with a diagnosed skin cancer or a suspicious lesion that needs to be removed for diagnosis or treatment.

It concerns younger patients and older people alike, as skin cancers are particularly common after several decades of sun exposure.

Treatment is tailored to the type of tumour, its extent, the patient's medical history and general health. Particular attention is paid to cancers located in sensitive anatomical areas, notably the face, where preserving function is essential.

To offer every patient appropriate oncological treatment, adapted to their state of health and the characteristics of their lesion.

Your journey,
step by step.

The techniques

Simple surgical excision

Removal of the lesion with appropriate safety margins, followed by direct closure when the suppleness of the tissue allows.

The techniques

Excision with margin control

Histopathological analysis of the resection margins, sometimes as a delayed procedure or using Mohs micrographic surgery for certain high-risk lesions.

The techniques

Local flap reconstruction

Moving neighbouring skin to cover the tissue defect while respecting the contours and aesthetic units of the face.

The techniques

Skin graft reconstruction

Harvesting skin from another area of the body when direct closure or a local flap is not appropriate.

The techniques

Complex reconstruction

Repair of large tissue defects, particularly of the nose, eyelids, lips or ears, sometimes in several surgical stages.

The techniques

Wide excision and associated oncological procedures

Notably for certain forms of melanoma, with discussion of a sentinel lymph node biopsy or further tests in line with guidelines.

Step 01

First consultation

This first meeting is an opportunity to examine the skin lesion and assess its size, location, clinical features and any functional consequences.

The results of a previous biopsy are reviewed when available. If the diagnosis has not yet been established, an appropriate diagnostic biopsy may be proposed, particularly for a suspicious pigmented lesion.

We discuss the surgical strategy, the planned excision margins, the options for reconstruction and any further tests. Any history of skin cancer, current treatments and risk factors are also taken into account.

To establish an accurate diagnosis and define an appropriate treatment strategy, prioritising oncological safety and the preservation of healthy tissue.

Step 02

Surgical planning

A second consultation may be arranged when the complexity of the lesion, the histopathology results or the need for a specific reconstruction justify it.

It is used to confirm the surgical strategy, specify the extent of the excision and present the different reconstruction options, as well as the expected scars.

The surgical risks, the type of anaesthesia and the post-operative course are explained in detail. For certain high-risk tumours, the strategy may be discussed at a multidisciplinary team meeting.

This additional consultation should not, however, needlessly delay the treatment of a suspicious lesion or a confirmed cancer.

To prepare a procedure that meets oncological and reconstructive requirements, with clear information about the results and the expected recovery.

Step 03 · The procedure

Anaesthesia

Usually local for small lesions. Local anaesthesia with sedation or general anaesthesia may be needed for extensive excisions or complex reconstructions.

Step 03 · The procedure

Duration

Generally between 30 minutes and 2 hours, sometimes longer depending on the size of the lesion and the complexity of the reconstruction.

Step 03 · The procedure

Setting

Performed in the practice in a suitably equipped environment or in the operating theatre, usually as a day case. Some reconstructions require a hospital stay.

Step 03 · The procedure

Technique

Excision of the lesion with appropriate margins, followed by direct closure, a local flap or a skin graft. Depending on the situation, reconstruction may be postponed until complete excision has been confirmed.

Step 03 · The procedure

Recovery

Varies with the location and extent of the procedure. A quick return to activities is often possible after a simple excision, whereas more complex reconstructions require a longer recovery period.

Step 04 · Follow-up

The first days

Monitoring of healing, dressing checks and pain management. Swelling, bruising or a feeling of tightness may appear, particularly on the face. Grafts and flaps require specific monitoring of their blood supply and healing.

Step 04 · Follow-up

The first weeks

Stitches are removed according to the location and how healing progresses. The final histopathology result is reviewed to confirm the nature of the tumour and that it has been completely removed. Further surgery or additional treatment may be needed if the margins are insufficient or in the presence of particular risk factors.

Step 04 · Follow-up

After 1 to 2 months

The tissues gradually soften and the scars begin to fade. Any functional limitations diminish. Dermatological or oncological follow-up is arranged according to the type of cancer and its level of risk.

Step 04 · Follow-up

After 3 to 6 months

The scars continue to mature. The aesthetic and functional result of the reconstruction can be assessed more precisely. Specific scar care or, more rarely, a secondary correction may be considered.

Step 04 · Follow-up

After 6 to 12 months

The scars continue to evolve and the reconstructive result gradually stabilises. Regular dermatological check-ups remain essential to detect any recurrence or new lesions. Their frequency and duration are adapted to the type of cancer, its stage and individual risk factors.

Common question

Can the cancer come back?

Yes, a skin cancer can come back, even after complete surgical excision. The risk of recurrence depends mainly on the type of cancer, its aggressiveness, its location and the quality of the excision margins. Basal cell carcinomas generally carry a low risk of recurrence after complete surgery, whereas certain squamous cell carcinomas and melanomas require closer monitoring. Regular dermatological follow-up is essential to detect any recurrence or the appearance of new lesions early.

Common question

Will I need reconstruction?

Whether reconstruction is needed depends on the size, depth and location of the lesion removed. Small defects can usually be closed directly, whereas larger lesions or those in delicate areas, such as the nose, eyelids, lips or ears, may require reconstruction with a local flap or a skin graft. The aim is to restore the appearance and function of the treated area as well as possible, while guaranteeing complete oncological excision.

Common question

How is the diagnosis confirmed?

Skin cancer is suspected during the clinical examination, sometimes supplemented by dermoscopy. Confirmation relies on histopathological analysis of a biopsy or of the surgically excised tissue. This examination precisely identifies the type of cancer and its characteristics and, after the procedure, allows the excision margins to be assessed. This information is essential for tailoring treatment and organising follow-up.

Common question

Will there be a visible scar?

Every surgical procedure leaves a scar, the extent of which depends on the size, depth and location of the cancer removed. Plastic and reconstructive surgery techniques make it possible to keep scars as discreet as possible, notably by placing them in the natural folds of the skin. With larger lesions, a change in contour or some asymmetry may sometimes remain, particularly on the nose, eyelids or lips. The aim is to preserve the appearance and function of the treated area as much as possible, while always giving priority to complete removal of the cancer.

Consultation locations

Consultations are booked directly through each clinic's own platform. Appointments are not taken by phone.

See the locations