Different Types Of Skin Cancer

4 March 2019/in Skin Surgery /by admin@staiano

Cancer is a very emotive word and when people hear the diagnosis of cancer they understandably will conjure images of prolonged unpleasant treatment and poor prognosis, but skin cancer can be different.

It can cover a range of different types of cancer from the relatively mild form which can be cured by minor surgery, through to the more aggressive types which can carry with them a poor prognosis.

There are three main types of skin cancer and they can usually be distinguished on their clinical appearance:

first is a BCC basal carcinoma
next an SCC squamous cell carcinoma,
and the other is malignant melanoma.

Before & After Photo Of SCC Skin Cancer Removal From The Top Lip

BeforeAfter

Malignant melanoma is in a category of its own, which is why the other types of skin cancer are sometimes known as the non-melanoma skins cancers.

They usually look quite different in that BCCs and SCCs are red patches of dry crusty skin which can be confused with a spot that does not heal up.

They sometimes ulcerate and may bleed or itch.

Before & After Photo Of Ulcerated BCC Skin Cancer Removed From Nose

Melanoma on the other hand tends to be a pigmented lesion, in that it is brown, can start in an existing mole, or present as a new mole.

It is usually identified by a change in a mole and it becomes bigger, smaller, or starts itching or bleeding.

They are both due to sun exposure (this is why I keep going on about having SPF on a daily basis not just when it is sunny outside).

However, melanoma is more associated with sunburn, particularly sunburn as a child, but it is very common in sunny climates like Australia.

BCC and SCC are more associated with chronic sun exposure and because our skin is exposed to the sun all the time, over the years this sun exposure can take its toll, which is why BCCs and SCCs are the more common type of skin cancer that we get as we get older and it is also why they are more common in sun exposed areas such as the face.

Melanoma is at one end of the spectrum and it can be quite a significant disease.

It can spread rapidly and can be associated with a very poor prognosis which is why if you have any moles that you are worried about you will need to get them checked out on an urgent basis.

Removal Of A Suspected Melanoma Skin Cancer From The Neck

BeforeAfter

On the other hand, BCCs and SCCs which do not tend to look like moles but more like red patches of skin or spots and can sometimes be confused as insect bites, are less aggressive, with BCCs being milder than SCCs.

BCC and SCC can often be cured by removing them and may only involve a minor operation with the main aim to make sure that they are removed completely and if they are completely removed then they may need no further treatment.

This is why they have to be excised and you should not consider other treatment such as curettage or shave because removal of normal skin all the way round and deep to the lesion needs to be attained in order to ensure they have been completely removed.

If you are concerned, then the bottom line is if you have any changes or are worried about it, then you should go to your GP or come and see us to get things checked out.

We will let you know if there is anything to worry about or whether you can simply just keep an eye on things.

Do not panic if you get a diagnosis of skin cancer because it might be one of the milder forms such as BCC which really is not what we normally associate with cancer because once BCCs are completely excised, they do not need any further treatment.

You simply just have to keep an eye out for further lesions because once you have had one you are at a higher risk of getting others.

It is important that we are all vigilant with our skin, look out for any moles or spots that are changing, and as always prevention is better than cure, so be sensible in the sun, keep covered up, use suntan lotion and regularly re-apply it, and without wanting to sound like a broken record, consider incorporating SPF into your daily regime of skin care.

Play safe in the sun.

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What is Life-Changing Surgery?

13 February 2019/in General, Skin Surgery /by admin@staiano

I was invited to a talk on the radio this morning about scar management following a story of a football supporter who had been attacked and had sustained a long laceration to his cheek.
The conversation revolved around the scarring and the emotional impact of scars and what can be done about it.

I am always cautious when talking about scar revision because sometimes people think that plastic surgeons can remove a scar but that is not true.
I think we get that reputation because when we make a scar, we choose where to put them and know how to hide them in natural skin creases or in areas of the body where there are concavities or shadows, so that they can blend in and once settled, can be difficult to see.

Of course, it is a different story with traumatic scars and they are usually a lot more obvious than surgically created scars.
There are things we can do to change the direction of the scar and to improve them if they are raised up or dented in, which is interesting, because the discussion moved onto the psychological impact of having scar revision.
It is true that the surgery itself is often quite minimal and usually done under local anaesthetic on a walk-in, walk-out basis and the results really can be truly life-changing – except when the definition of a minor operation is one that is not happening to you.
We as surgeons can sometimes think that we are performing minor surgery, but for the patient it can bring tremendous relief from the emotional impact of having an obvious scar, particularly if it is on the face and people’s eyes are drawn to it and they keep asking you about it.
If we can do something to help it blend in and make it less obvious, it can allow you to be you and not to be defined by your physical features.

And this is true of all cosmetic surgery.

It is often deemed to be unnecessary or for vanity reasons, but I think people’s perception is far off the average person seeking cosmetic surgery.
It is usually done for them and not for anyone else and they just want to feel more confident and happier about their appearance.

It was interesting talking to Danny Kelly this morning on BBC WM because it really made me think about the impact that we have on people’s lives and sometimes we can lose sight of this and get caught up in ‘the what we are doing’ rather than ‘the why we are doing it’.

I truly believe that cosmetic surgery can significantly improve people’s quality of life and I am often upset by the adverse media attention, which happens to be part of the positive image of plastic surgery this morning, as this is always what we are trying to achieve because everyone deserves body confidence.

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Our ‘See & Treat’ On The Day Service

18 January 2019/in General, Skin Surgery /by admin@staiano

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One of the founding principles of my clinic is to deliver a patient experience over and above expectation.

I spend a lot of time thinking about how the clinic is perceived by potential patients, to work out ways that we can deliver a better service, give more relevant information, and increase patient satisfaction.

I often speak about having outcome measures, which is quite common in medicine, but cosmetic surgery is one of those areas that fortunately has very few complications and morbidity associated with it.

It is therefore difficult to get objective outcome measures, such as return to theatre rates, infection rates, or implant failures rates, as these are universally very low, so it is hard to distinguish between practitioners on these bases.

The main outcome measure that I feel we are judged on is patient satisfaction and I think this is an idea that has got room for significant improvement amongst providers of cosmetic surgery and in fact across the medical field.

One of the many unique features of the Staiano Clinic is that we offer a ‘See & Treat’ service.

This means that patients can come to the clinic with a problem that we can treat in our local anaesthetic operating theatre, such as a mole, a cyst, a split earlobe, unwanted tattoo, inverted nipple, or areola reduction and have the procedure done on the same day as the consultation if they wish.

Clearly not everybody would want this and many patients are happy to come for a FREE consultation in the first instance so they know what to expect and then book in for the procedure at a later date.

Of course, this is perfectly reasonable and the way that most medical practices operate.

However, because I own the whole clinic and so control the minor operating room, I can decide what the best use of time in the operating room is.

Classically in any hospital, operating theatre time is the most expensive commodity and so hospitals will aim to maximise efficiency and utilisation of the operating theatre which is best done by having pre-booked operating lists.

A see & treat clinic, when the patients may or may not have a procedure, is not an efficient use of the operating theatre as it could result in the operating theatre being booked out for an hour, and the patient may decide not to go ahead with the procedure for any reason.

However, I see the benefit to patients, particularly if they have a troublesome mole or some other lesion that they know they want to have removed and they do not particularly want to come to see the doctor for consultation and take more time off work to come back to have the procedure, and so while the see and treat clinic is not an efficient use of the operating space, it does result in high patient satisfaction and is therefore achieving the ultimate goal of my clinic to give the best possible result to every patient and to do everything we can to ensure that we can deliver a world class service.

If you book a see and treat appointment with us we ask for £100 deposit to secure the slot and this is fully refundable if you are not suitable.

You can still come and have a consultation with a plastic surgeon and if you remain unsure, simply book in to have the procedure another day or just go and have a think about things.

It is one of the benefits of owning my own clinic that I can make decisions like this.

If the clinic was run by a commercial organisation, this would not be allowed because it is always about the bottom line with profits and efficiencies, and whilst I accept that these are important and realise that I am running a business, I also believe that when we stand out and go the extra mile for our patients it is a move towards my goal of delivering a national brand that stands for quality and service in plastic surgery.

That is my goal and I truly believe we are delivering a world class service and will continue to innovate and grow, so that we can find new ways to give you a better service and make your life a little bit easier.

Coming to a plastic surgery clinic or any doctor’s surgery can be daunting and I have set up the clinic so that it is a calm and peaceful environment that is non-threatening and more akin to a five star hotel than a doctor’s surgery.

I have built the clinic around ethics and values and everyone that works here knows what we are trying to achieve and are aligned with our goals.

I have always wanted to create something that I am proud of and it has driven me throughout my medical career and all the decisions I make.

I am very proud of the service we offer and I can safely say that every decision is made for patient satisfaction, comfort, peace of mind, and expectations at its heart.

The freedom to build the clinic how I want, employ the staff that I choose, and utilise the facilities as I feel best has been liberating and we have been running the see and treat clinic for the last five years now and I believe it is a great comfort and convenience to many patients and so we will continue to do so.

We are always asking for feedback and so if there is anything that you feel that we could do better or differently, please let us know.

We are constantly looking for ways to surprise and delight patients and we are always looking to get a wow factor.

This is right from having the most highly trained surgeons in the country so that the surgical results will be second to none, but also from the moment you walk through the door, meet the staff, and engage and interact with us both in person and in the virtual world with our closed Facebook group for patients and our other social media channels.

If you think you like to come for a see and treat appointment please let us know before booking so we can ensure that we have got enough time, but rest assured that there will be absolutely no obligation to proceed, so if your surgeon feels that you may not be suitable for surgery on the day, or if for any reason you are not sure whether you want to proceed, there is absolutely no obligation and no charge as any deposit paid is fully refundable with no questions asked.

If you have any questions, you can always join me on Facebook, Instagram and YouTube where I do a live Q and A every Tuesday at 7 p.m. and I will be available live to interact and discuss any issues.
Feel free to leave a comment below, or drop us an e-mail.

If you want to come for a consultation with one of our plastic surgeons, please call or email us or fill in the on-line contact form.

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Laser excision of a mole versus surgical excision

14 November 2018/in Skin Surgery /by admin@staiano

It is not uncommon for people to enquire about laser excision of a mole here at the Staiano Clinic as I think that sometimes people feel that it is somehow better than surgical excision.
Anything with the term laser in it is deemed to be futuristic and therefore better than the old-fashioned ways, and indeed lasers have been a great advance in the field of plastic surgery and are very useful in many situations.

We do not offer laser excision of moles here at the Staiano Clinic, however we would be happy to talk to you about it.

If you wanted laser excision, it would always be best to talk to a practitioner who does offer laser excision of moles, because they would be best placed to tell you the pros and cons and the reasons why they offer it.
The main point to consider, is that if you want to have your mole removed, then it will need to be destroyed in some way. The sort of lasers that are used for mole removal are quite destructive and cut the skin in a similar way to a scalpel.

One of the reasons people feel that laser is preferable to surgery is because they do not want the scar.
However, if the mole is going to be destroyed then it will leave a scar or a mark whatever modality is used.
The pattern of scarring might be different and that is true for the different types of mole excision.

One of the main benefits of laser is that multiple moles can be targeted at the same time, but one of the big downsides is that laser destroys the tissues and so the mole cannot be sent for histology, and it is good practice certainly for pigmented lesions, that they are sent away for histological analysis to be sure that there is nothing to worry about.

There are no moles that are removed by laser excision that cannot be removed by surgical excision and we are all plastic surgeons here at the Staiano Clinic and we specialise in the surgical excision of moles.

There are clinics that do offer laser excision of moles, but you have to be absolutely sure that they are benign before going down that route.

Ideally you would find a plastic surgeon who does laser excision of moles and surgical excision to get a balanced view.

The fact is that laser is often performed by non-plastic surgeons who may not have the ability to offer surgical excision, so it is sometimes hard to get a balanced view and opinion, and so my advice would be to look at the results of different practitioners and choose someone you can trust, who seems to give results and have happy patients because you will find, like with most things, there are many ways to crack a nut.

We are very comfortable with performing surgical excisions of moles here at the Staiano Clinic and we offer free consultations with one of our plastic surgeons if you would like to come along and have an assessment and a chat.
You can also download our guide with details of when you should worry about your mole here.
We are one of the few clinics to offer a see and treat service where you can come to the clinic and have your mole assessed and removed on the same day, and while we do ask for a deposit, there is no obligation to proceed and the deposit is fully refundable if you do not proceed with the surgery on the day.

If you have any questions and want to get in touch, then contact us on the website or on Facebook where I do a live Q and A on Facebook every Tuesday at 7 p.m. Please visit our Facebook page if you would like to put a question directly to Jonathan.
Feel free to leave a comment below, or drop us an e-mail.
If you want to come for a free no obligation consultation with one of our plastic surgeons, please call or email us or fill in the on-line contact form.

Xanthelasma Removal

6 August 2018/in Skin Surgery /by admin@staiano

Xanthelasma are white plaques or spots that develop around the eyes.

The treatment involves surgical removal which can be done here in the clinic on a walk-in, walk-out basis, and this is something we can do with our see and treat service when you can have your xanthelasma removed on the same day as your consultation.

Xanthelasma are cholesterol deposits and so it is important that you have your cholesterol checked as they could indicate high levels of cholesterol which may predispose to heart disease.

It is possible to have a xanthelasma with a normal cholesterol level, but it is worth getting this checked out with your GP.

Removal of any skin lesions will leave scars, but because of the position of xanthelasma which are normally around the eye, scars in this area heal so well that they can be difficult to see.

There are natural lines and creases around the eyelids which are formed by the eyelids opening and closing, and as plastic surgeons we aim to hide our scars in these natural lines, so that once they have settled they blend in with the facial features and are almost invisible even when you look closely.

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Feel free to leave a comment below, give us a call on 0121-454 3680 or drop us an e-mail.

Three reasons to have your mole removed (and three reasons not to)

14 May 2018/in Skin Surgery /by admin@staiano

There are two sides to every coin and when patients ask us, should I have this mole removed, it is sometimes difficult to give a straight answer and we will often come back with:

‘it depends’

Three reasons to have your mole removed:

You think it might be cancer. This is the main one. In these situations then the decision is easy and you really should have your mole removed. It is important to be vigilant and look out for the signs of cancer, (see our guide when to worry about a mole) and if there has been any recent change in your mole and any suspicion of cancer, then this trumps all the other reasons and the mole should be removed and sent away for histological analysis.

Peace of mind. If the mole is not obviously cancerous, then we will often say that you can keep an eye on it and get in touch if there are any changes. We offer free consultations so you can always come back to the clinic to get it checked out and I am sure your GP will be able to keep an eye on things for you. However, some people are worried and when they start focusing on a particular mole, they are not sure whether it has changed of not ‘has it got bigger, has it just started itching, or is that me?‘. Sometimes the moles can be in difficult areas like your back, and it is difficult to keep an eye on things and so it might be easier to have it removed and then the problem has gone once and for all.

I do not like the look of it. This is one of the most common reasons that we see patients in the clinic and we hear things like ‘I hate my mole’, or ‘I have never liked it’, or it may be nuisance and can be raised and catch on things, which makes them bleed or they may have hairs growing from them and it is this reason that probably needs the most discussion, because as you will see from the reasons not to remove a mole, mole removal does leave a scar and so you need to be confident that the scar will be preferable to the mole.

Three reasons not to remove your mole:

It will leave a scar. Now just because we are plastic surgeons, it still does not mean that we do not leave scars. Of course a large part of our training is in tissue handling and wound closure, so we do take great care to leave neat scars and we have tricks of the trade that allow us to hide the scars or orientate them in such a way that makes them less obvious. However, at the end of the day removing a mole will leave a scar of some sort. It might be a thin line or a faint patch, depending on how it is removed (see shave or excision of mole) and scars do tend to fade particularly when they are on the face, and so it is often difficult to see where they were. However, in the early stages they are often red and obvious and you need to look after them to ensure that you get the best result possible.

Your mole has always been a part of you. We specialise in breast and body contouring here at the Staiano Clinic and you cannot underestimate the effects of changing your body in some way. If you have had a mole for a long time, particularly if it is on a prominent area of your face, this is something that people will associate with you and you may look completely different without it. It can sometimes be difficult to come to terms with your new look and we have seen lives transformed with a simple 20 minute procedure removing a prominent mole on the nose or the forehead and it can be tremendous to see the positive effect of what some might call a ‘minor’ operation. Whilst the only person you need to convince is yourself, it can be helpful to talk to friends and family members to get their take on things, because at the end of the day a mole is a natural attribute whereas a scar is not. This is particularly true for people who want multiple moles removed because multiple scars might look more obvious than the moles themselves.

Once it has gone you cannot go back. Obviously if there is a worry about skin cancer your mole needs to be removed, but if it is more of a cosmetic issue it is always good to take time to consider things and weigh up the pros and cons, because if you are not sure you can always go away and come back another day. Even if you come to one of our see and treat sessions, we will never pressurise you into having a mole removed, because we realise it can be a significant decision. There is no harm in delaying things, having a think, and talking it over with your friends and family. We will still be here a month, six months, or in a year’s time. You will never regret delaying the decision to have it removed, although you may think I wish I had done that years ago. However, once it is removed there is no turning back and the scar is permanent, although we would stress it is often more obvious in the early stages and so do not be too alarmed because it will fade.

For more details on what to look out for with a mole download our free guide here.

If you want to come for a free no obligation consultation with one of our plastic surgeons, please call or email us or fill in the on-line contact form.
Or you can ask our director, Jonathan Staiano, a question LIVE on Facebook at 7 o’clock every Tuesday evening, so feel free to drop in.

How To Reduce Enlarged Earring Holes

23 January 2018/in Skin Surgery /by admin@staiano

How to reduce enlarged earring holes

There is very much a fashion for gauging (stretching) or tribal piercing, which involves having your ear pierced and then having the hole gradually increased in diameter so that you can put bigger and bigger earrings in.
The problem with the fashion is that as you increase the diameter of your earring hole there is only one way you can go.
You can either choose to keep it at the same diameter or increase the diameter.
If you decided that you no longer liked the look of it or if you need to get a job or start a career where having an enlarged earring hole is not welcome, then you might start to regret things.
If you start to put progressively smaller earrings in, they will just start to fall out and the skin of your ear lobe will not shrink back.

But don’t panic,

because it is relatively simple to fix the problem.
Earlobe Repair is something we can do here in the clinic under a local anaesthetic on a walk-in, walk-out basis, and in fact, we can see and treat you on the same day as your consultation in our fully equipped minor operating suite that we have here on site.
The procedure takes about 45 minutes and can transform the look of any ear lobe no matter how large the enlarged earring hole has been stretched to.
It will leave a scar which will be slightly red to start with, but this tends to fade quite nicely and so the hope is that it will be difficult to see in the future.

If you wanted to go and get your ear re-pierced then this is perfectly possible, although we advise that you pierce it slightly off the scar because the scar will be weaker than the normal ear lobe skin.
For more details or to book a free consultation please contact us by phone or e-mail and we would like to see if we can help you.

Ear lobe reduction for enlarged earring holes is one of the specialties here at the clinic

and it can be quite transformational the difference that can be made in just a short and relatively simply operation.
So drop us a line and we would be more than happy to see if we can help.
And you can read more about Earlobe Repair here

Scar Revision

12 December 2017/in Skin Surgery /by admin@staiano

Scar Revision At The STAIANO Clinic

You may think that scar revision is bread and butter for a plastic surgeon, but it is important to be aware of what is possible when it comes to considering revision of your scar.
It is not possible to remove scars completely, but plastic surgeons are trained in techniques to alter and improve scars so that they can be hidden or blend in with their surroundings.
If you think that you might be a suitable candidate for scar revision, then watch this video where our director, JJ Staiano, talks about what can be achieved with plastic surgery to help improve and reduce scarring.

What Scars Are Suitable For Scar Revision?

Not all scars are suitable for scar revision and you would be welcome to send us a photograph of your scar so that we can give you an assessment on whether we can help.
Scar revision is particularly suitable for scars that are stretched or indented or scars that are lying in an unfavourable orientation. This is usually scars that are caused by some sort of trauma or injury rather than scars that have been made following surgery.
If you have a surgical scar, then it could be raised and lumpy and this is known as a keloid or hypertrophic scar. Keloid scars are best managed by a qualified surgeon or dermatologist as they are difficult to treat and there is a risk of causing more keloid scarring if surgery is performed.
We have a wealth of options to treat problematic scars at The STAIANO Clinic ranging from non-surgical treatments such as silicone gel that can be applied to your scars to steroid injections that we can perform here at the clinic through to surgical revision to improve the look of your scar.

Before Scar Revision – Puckered Scar

After Scar Revision – Puckered Scar

Before Scar Revision – Stretched Scar

After Scar Revision – Stretched Scar

When plastic surgeons perform scar revision surgery, they are creating new scars and so the aim is to create a new scar that is better than the old scar. It is very much a bespoke service that we offer and we will assess your scar and take a full history so that we can offer you the best treatment for your scar and give you the best result possible.

When Is The Best Time To Undertake Scar Revision Surgery?

All scars take 6 to 12 months to mature and so you should not consider scar revision until your scar has fully matured and is going to be as soft and supple as it is going to get.
It may sound counter-intuitive to wait until your scar has fully settled before undergoing revision, but it it is important for it to have softened and settled fully before undergoing further surgery.

Want To Find Out More About Scar Revision?

Find out more about removing your scar on our scar removal page.
All of the surgeons at The Staiano Clinic are fully trained plastic surgeons and have extensive experience in managing scars and obtaining the best outcomes possible.
For more information, call us now on 0121-454 3680 to book a FREE consultation with a Consultant Plastic Surgeon or you can send us a photograph of your scar to [email protected] and we will get back to you with an idea of what can be achieved.

Tattoo Removal

16 November 2017/in Skin Surgery /by admin@staiano

Have you looked in to tattoo removal but don’t know where to turn?
Do you have a tattoo that you no longer like? Or Regret? Have you tried laser but it just doesn’t seem to be working? Well we might be able to help.

If laser fails, we may be able to help

We perform tattoo removal by excision. This is were a plastic surgeon surgically removes your tattoo and it can be completely gone in as little as one session.
It involves removing the tattoo by cutting it out of the skin.
There is a couple of things that are important when considering whether your tattoo is appropriate for excision, the first is the size of the tattoo and the second is the location of the tattoo. If you want to find out more about this and whether your tattoo is suitable for excision watch Jonathan’s video:

To see further examples of our work and testimonials from patients check out our tattoo removal by excision page.
If you would like to know if your tattoo is suitable for removal by excision, then you can send us a photograph and we will let you know what would be involved and how much it would cost.
You can email us at [email protected] or you can call us on 0121 454 3680.

Shave Excision of Your Mole

24 October 2017/in Skin Surgery /by admin@staiano

Shave Excision Mole
Have you got a mole?
Did you want to get it removed?
Not sure of what the best way to remove it is?

Formal excision vs shave excision?

You can read more about mole removal at The STAIANO Clinic here.
In this video Jonathan discusses the different ways plastic surgeons can remove your mole. He talks about shave and formal excision as techniques of removing your mole and discusses the benefits and risks of having each of these.
He also talks about the criteria your mole must fulfil to have each of these procedures, for example a skin lesion will only be shaved if it is benign. If you are unsure if your mole is benign, we have information on when you should worry about a mole here.

If you would like to see how shave excision of a mole is performed, then you can watch LIVE surgery being performed in this video:

This is a before and after example of a shave excision of a mole on the forehead:

Removal of 3 moles on the forehead by shave excision

This is a before and after example of a formal excision of a mole on the forehead:

Formal excision of mole on forehead

We hope you found this helpful and if you would like any more information, please email us or call us on 0121 454 3680.

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