Oculoplastic · Lump & Lesion Excisions
The thin, sun-exposed skin of the eyelids is one of the more common sites for skin cancer. Mr Sultan assesses, removes and reconstructs eyelid tumours, aiming for the best balance of cancer clearance, eyelid function and appearance.
Available at Kelsall Surgical Centre, Cheshire, and iSIGHT Clinic, Southport.
Background
The great majority of eyelid skin cancers are basal cell carcinoma (BCC) - a slow-growing skin cancer that very rarely spreads elsewhere in the body, but which can gradually invade and damage local eyelid tissue if left untreated. Squamous cell carcinoma (SCC) is less common on the eyelid and can behave slightly more aggressively. Both are related to cumulative sun exposure over a lifetime, and the eyelids - thin-skinned and often under-protected by sunglasses or hats - are a recognised site for both.
Signs worth having checked include a lump or sore that doesn't heal, a lesion that's slowly growing or changing shape, loss of eyelashes over a patch of lid margin, or an area of skin that bleeds or crusts repeatedly. Most eyelid lesions turn out to be entirely benign - but persistent or changing lesions are always worth a specialist opinion.
The Two-Stage Approach
For most eyelid tumours, Mr Sultan uses a staged approach that prioritises complete cancer removal before committing to the final reconstruction.
The tumour is removed with a margin of surrounding tissue, and the defect is often left to heal temporarily, or loosely closed, while the specimen is sent for histopathology.
A pathologist examines the tissue under a microscope to confirm the diagnosis and check that the margins around the tumour are clear of cancer cells - usually taking around a week.
Once clear margins are confirmed, the eyelid defect is reconstructed - typically about a week after the initial excision - using techniques tailored to the size and position of the defect, aiming for the most natural functional and aesthetic result.
For smaller, lower-risk lesions where the diagnosis and extent are more predictable, removal and reconstruction can sometimes be carried out in a single sitting. Mr Sultan will advise which approach is appropriate for your particular lesion.
Reconstruction
The eyelid isn't just skin - it's a precise, moving structure that protects the eye with every blink. Reconstruction after tumour removal draws on a range of specialist techniques - including local skin flaps, grafts and lid-sharing procedures - chosen according to the size, depth and position of the defect, with the aim of restoring an eyelid that closes properly, protects the eye, and looks as natural as possible.
Mr Sultan manages complex peri-ocular tumours and reconstruction regularly through his substantive NHS post at a busy tertiary referral unit, working closely alongside colleagues in ocular oncology on the most demanding referred cases.
Persistent or changing lesions deserve a specialist opinion.