Introduction
Skin cancer is highly treatable when detected early. A lesion that changes in size, shape, or color, repeatedly bleeds or crusts, does not heal, or simply looks different from your other moles should be evaluated.
At Cabo Plastic Surgery, suspicious skin lesions can be evaluated and, when indicated, biopsied in the office under local anesthesia, with specimens sent to our dermatopathology partner for analysis.
When skin cancer requires surgical removal, Dr. Roberto López Konschot plans both the excision and the reconstruction, particularly in sensitive areas such as the face, nose, eyelids, lips, ears, and scalp.
The priority is appropriate cancer treatment first, followed by reconstruction designed to preserve function, anatomy, and appearance whenever possible.
The treatment pathway — from evaluation and biopsy to removal and reconstruction — depends on the diagnosis, location, and complexity of the lesion.
Skin Cancer Removal & Reconstruction at a Glance
| Procedure | Skin Cancer Removal & Reconstruction |
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| Purpose | Remove confirmed skin cancer with appropriate surgical margins and reconstruct the resulting defect when necessary. |
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| Common Diagnoses | Basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and selected melanoma cases requiring surgical management. |
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| Biopsy | Performed when indicated to establish the diagnosis before definitive treatment. |
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| Anesthesia | Local anesthesia for many procedures; sedation may be appropriate for selected or more complex cases. |
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| Treatment Setting | Many biopsies, excisions, and selected reconstructions can be performed in the office. |
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| Margin Assessment | Removed tissue is examined to determine whether cancer extends to the surgical margins. |
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| Reconstruction | Primary closure, local flap, or skin graft, depending on the size, depth, and location of the defect. |
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| Sutures | Usually required after surgical excision and reconstruction. |
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| Recovery | Varies according to the location, size of the defect, and reconstruction required. |
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| Follow-Up | Includes pathology review, wound monitoring, and recommendations for ongoing skin surveillance. |
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The first step is recognizing when a skin lesion deserves further evaluation.
When Should a Skin Lesion Be Evaluated?
A skin lesion should be evaluated when it is new, changing, persistent, or noticeably different from your other spots or moles. Consider an evaluation if you notice:
- A mole or spot that changes in size, shape, or color.
- A lesion that bleeds, crusts, ulcerates, or does not heal.
- A new or changing growth that looks different from your other moles.
- Persistent itching, tenderness, or other symptoms in a lesion.
- Significant cumulative sun exposure.
- A personal history of skin cancer.
You do not need a confirmed diagnosis before scheduling an evaluation. If a lesion is concerning, Dr. Roberto López Konschot can examine it and determine whether observation, biopsy, or another form of evaluation is appropriate.
When a lesion requires biopsy, the pathology results determine what treatment — if any — is needed next.
From Evaluation to Diagnosis
Treatment begins with determining what the lesion is before deciding how it should be removed.
Clinical Evaluation
Dr. Roberto López Konschot examines the lesion and reviews relevant factors such as its appearance, changes over time, symptoms, sun exposure, and previous history of skin cancer.
Biopsy
If further evaluation is needed, a biopsy can often be performed during the same office visit under local anesthesia. A small tissue sample — or, in selected cases, the entire lesion — is removed and sent to a dermatopathology specialist for examination.
Pathology Results
The pathology report establishes the diagnosis and provides information needed to determine the appropriate next step. If skin cancer is confirmed, Dr. López Konschot reviews the findings with you and explains the recommended treatment.
Basal cell carcinoma, squamous cell carcinoma, and melanoma require different treatment considerations, so the surgical plan is based on the specific diagnosis rather than using the same approach for every skin cancer.
Types of Skin Cancer We Treat
The three major types of skin cancer differ in how they behave and how they should be managed. The diagnosis determines the treatment plan, surgical margins, reconstruction, and follow-up.
Basal Cell Carcinoma (BCC)
Basal cell carcinoma is the most common type of skin cancer. It usually grows slowly and rarely spreads to distant parts of the body, but it can progressively damage surrounding tissue if left untreated.
TreatmentBCC frequently develops on sun-exposed areas such as the face, nose, ears, and scalp. Surgical treatment aims to completely remove the cancer while preserving as much healthy tissue as appropriate. Facial defects may require careful reconstruction depending on their size and location.
Squamous Cell Carcinoma (SCC)
Squamous cell carcinoma can behave more aggressively than BCC and, in some cases, can spread beyond the original site.
TreatmentIt commonly appears on chronically sun-exposed skin and may present as a scaly, thickened, crusted, or ulcerated lesion. Treatment depends on factors including the tumor’s size, location, pathology, and individual risk characteristics.
Melanoma
Melanoma is less common than BCC and SCC but has a greater potential to spread to lymph nodes and other organs. It may appear as a new pigmented lesion or a mole that changes in size, shape, or color.
TreatmentEarly melanoma can often be treated successfully with surgery. However, melanoma requires a different treatment pathway from most BCCs and SCCs. Depending on the pathology and stage, treatment may require wider excision, lymph-node evaluation, additional testing, or referral to other specialists.
When surgical removal is appropriate, the next priority is complete excision while preserving healthy tissue and planning for the resulting defect.
Skin Cancer Excision & Margin Assessment
Once skin cancer has been diagnosed, the goal is to remove the tumor with appropriate surgical margins while preserving healthy tissue whenever possible.
Surgical Excision
Dr. Roberto López Konschot removes the lesion according to the type of skin cancer, its size, location, and pathology findings. The excised tissue is then submitted for pathological examination to assess the surgical margins.
What Are Clear Margins?
A clear or negative margin means that no cancer cells are identified at the outer edge of the tissue removed. A positive margin means cancer cells extend to the edge, indicating that additional treatment or excision may be necessary.
What Happens If the Margins Are Not Clear?
If cancer remains at a surgical margin, Dr. López Konschot will discuss the appropriate next step. Depending on the type, location, and pathology of the tumor, this may involve additional excision or referral for another specialized treatment approach.
When Is Reconstruction Performed?
The timing of reconstruction depends on the type of skin cancer, the method used to assess the margins, and the complexity of the defect. When appropriate margin clearance has been established, reconstruction can be planned using the technique best suited to preserve function and appearance.
After the cancer has been appropriately removed, attention turns to restoring the area while preserving normal anatomy, function, and appearance.
Reconstructing the Defect
Removing a skin cancer may leave a defect that cannot always be closed simply, particularly on the nose, eyelids, lips, ears, scalp, and other facial areas. Reconstruction is selected according to the defect’s size, depth, location, and surrounding anatomy.
Primary Closure
For smaller defects, the surrounding tissue may be brought together directly.
How it worksThe incision is closed in layers with attention to minimizing tension, preserving nearby structures, and positioning the scar as favorably as possible.
Local Flap Reconstruction
When direct closure could distort an important structure — such as the eyelid, nostril, or lip — a local flap may be used. Nearby skin and tissue are carefully repositioned to reconstruct the defect while maintaining the natural relationships of the surrounding anatomy.
Why it is usedLocal flap reconstruction is particularly valuable on the face because the tissue used generally provides a closer match in color, thickness, and texture.
Skin Grafting
When surrounding tissue cannot adequately close the defect, a skin graft may be appropriate. Skin is taken from another area of the body and transferred to cover the surgical site.
How it worksDonor-site selection and graft placement are planned with both healing and the final appearance in mind.
Will There Be a Scar?
Yes. Any surgical removal and reconstruction leaves a scar. The goal is not to promise a scarless result, but to place and manage the scar as carefully as possible while preserving function and normal anatomy.
Scars typically change and mature over time, and the final appearance depends on the size and location of the original cancer, the reconstruction required, and individual healing.
Recovery & Follow-Up
Recovery after skin cancer removal depends on the size and location of the lesion, the extent of excision, and whether primary closure, a local flap, or a skin graft is required.
Early Recovery
Mild swelling, bruising, tenderness, and temporary numbness may occur around the surgical area. You will receive specific instructions for wound care, activity, and protecting the treated area while it heals.
When sutures are used, the timing of removal depends on the location and type of reconstruction. More complex reconstructions may require additional follow-up visits.
Pathology Review
The final pathology report is reviewed to confirm the diagnosis and margin status. Dr. López Konschot discusses the results with you and determines whether any additional treatment or evaluation is necessary.
Ongoing Skin Surveillance
A history of skin cancer increases the likelihood of developing additional skin cancers. Follow-up should therefore extend beyond healing from the procedure and include ongoing skin surveillance and appropriate sun protection.
Depending on the type of cancer and individual risk factors, continued follow-up with a dermatologist or other appropriate specialist may also be recommended.
Scar Maturation
The surgical area continues to change after the wound has healed. Scars are often more noticeable initially and typically soften and mature over the following months. Final scar appearance varies according to the location, reconstruction, sun exposure, and individual healing.
Careful reconstruction and follow-up are especially important when skin cancer involves areas where even a small defect can affect both appearance and function.
Why Choose Cabo Plastic Surgery?
Skin cancer treatment begins with appropriate removal. When surgery involves the face or another sensitive area, reconstruction also requires careful attention to anatomy, function, and appearance.
- Board-certified plastic and reconstructive surgeon with more than 20 years of surgical experience.
- Advanced training in craniofacial surgery and facial aesthetics, particularly relevant to reconstruction of the nose, eyelids, lips, ears, scalp, and face.
- Excision and reconstruction planned together, with the anticipated defect considered before surgery.
- Multiple reconstructive techniques, including primary closure, local flaps, and skin grafts.
- Dermatopathology collaboration for biopsy and surgical specimens.
- Direct postoperative care, with Dr. López Konschot personally monitoring healing and reviewing pathology findings.
- Post-procedure consultations are included as part of your care.
Understanding the potential risks and limitations is also an important part of treatment planning.
Risks & Considerations
Skin cancer removal and reconstruction are generally well tolerated, but all surgical procedures involve potential risks. These vary according to the type and location of the cancer, size of the defect, and reconstruction required.
Potential considerations include:
- Bleeding, infection, swelling, or delayed wound healing.
- Scarring or changes in skin color, texture, or sensation.
- Partial or complete loss of a skin graft or flap.
- Temporary or persistent changes in nearby structures or function.
- Positive surgical margins requiring additional treatment.
- Recurrence of the skin cancer.
- Development of additional skin cancers in the future.
For lesions involving the eyelids, nose, lips, ears, or other functionally important areas, reconstruction is planned carefully to minimize distortion while achieving appropriate cancer treatment.
Individual risks and alternatives are discussed before treatment based on the diagnosis and proposed procedure.
The following questions address common concerns about biopsy, skin cancer removal, reconstruction, margins, and follow-up.
Frequently Asked Questions
Evaluation & Biopsy
Do I need a referral to have a suspicious lesion checked?
No. You can schedule an evaluation directly with Dr. Roberto López Konschot. If a biopsy is indicated, it can often be performed during the same appointment.
How long does a skin biopsy take?
A typical skin biopsy takes approximately 15–20 minutes and is performed under local anesthesia. The type of biopsy depends on the lesion and the information needed for diagnosis.
How soon will I receive biopsy results?
Results from the dermatopathology partner are typically available within a few business days. Dr. López Konschot reviews the pathology report with you and discusses the next steps.
What happens if my biopsy shows skin cancer?
The next step depends on the type of skin cancer, pathology findings, location, and extent of the lesion. Dr. López Konschot will explain the recommended removal and whether reconstruction is likely to be necessary.
Removal & Margins
What does “clear margins” mean?
Clear or negative margins mean that no cancer cells are identified at the outer edges of the tissue removed. If cancer extends to a margin, additional treatment or excision may be necessary.
What happens if the margins are not clear?
The appropriate next step depends on the type and location of the cancer and the pathology findings. Additional excision or referral for another specialized treatment approach may be recommended.
Can skin cancer be removed under local anesthesia?
Yes. Many skin cancers can be removed under local anesthesia, particularly smaller lesions and office-based procedures. More complex cases may require sedation or another anesthesia approach.
Reconstruction & Results
Will skin cancer removal leave a scar?
Yes. Any surgical excision leaves a scar. The goal is to remove the cancer appropriately and then position and manage the scar as carefully as possible while preserving function and surrounding anatomy.
When is a local flap or skin graft necessary?
A local flap may be appropriate when direct closure could distort structures such as the eyelid, nostril, or lip. A skin graft may be considered when surrounding tissue is insufficient to close the defect.
Why choose a plastic surgeon for facial skin cancer reconstruction?
When removal creates a defect on the nose, eyelid, lip, ear, or another sensitive facial area, reconstructive planning can be especially important. Plastic-surgery expertise allows the defect, surrounding anatomy, function, and eventual scar to be considered as part of the surgical plan.
Follow-Up & Recurrence
Can skin cancer come back after removal?
Yes. Recurrence is possible even after treatment, although the risk varies by cancer type and individual tumor characteristics. This is one reason appropriate margin assessment and follow-up are important.
Will I need continued skin checks after treatment?
Yes. A history of skin cancer increases the risk of developing additional skin cancers. Continued skin surveillance, sun protection, and follow-up with the appropriate physician are recommended.
Does melanoma require different treatment?
Often, yes. Melanoma treatment depends on factors such as tumor depth, pathology, and stage. Some patients may require wider excision, lymph-node evaluation, additional testing, or multidisciplinary specialist care.
Treatment cost depends on whether care involves biopsy alone, straightforward excision, or more complex removal and reconstruction.
Cost & Pricing
The cost of skin cancer treatment depends on whether care involves biopsy, straightforward surgical excision, or removal followed by reconstruction.
| Treatment | Cabo Plastic Surgery — Starting Price |
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| Biopsy + Dermatopathology Analysis | $350 USD |
| Simple Excision | $1,000 USD |
| Excision + Reconstruction | Quoted individually |
If sedation is clinically appropriate or requested, it is administered by a board-certified anesthesiologist, and an additional anesthesia fee applies.
Post-procedure consultations, review of pathology results, and postoperative follow-up are included as part of your care at no additional charge.
Insurance & Reimbursement
Skin cancer treatment is a medical rather than cosmetic procedure, but insurance coverage varies significantly by policy, country, provider network, and treatment.
Patients should confirm coverage directly with their insurer before treatment. Cabo Plastic Surgery can provide relevant medical documentation to support a reimbursement claim when applicable.
For patients who live outside Los Cabos, treatment planning also considers pathology timing, follow-up, and when it is appropriate to travel.
International Patients & Visitors
Patients who live outside Los Cabos can still undergo evaluation and treatment, but pathology results and appropriate follow-up should be considered when planning travel.
If you are visiting Los Cabos and have a concerning lesion, an in-person evaluation and, when indicated, a biopsy can often be performed during your stay. Biopsy results are typically available within a few business days.
If skin cancer is diagnosed, Dr. Roberto López Konschot will review the pathology findings and determine whether treatment can appropriately be completed in Los Cabos or whether additional evaluation or specialist care is recommended.
Patients undergoing excision or reconstruction should allow adequate time for early healing and postoperative evaluation before traveling home. The recommended stay depends on the location and complexity of the procedure.
If you have a lesion that concerns you, the first step is simply having it evaluated.
Have a Suspicious Skin Lesion Checked
If you have a new, changing, bleeding, nonhealing, or otherwise concerning skin lesion, schedule an evaluation with Dr. Roberto López Konschot.
When appropriate, a biopsy can often be performed during the same appointment. If treatment is required, you will receive a clear explanation of the diagnosis, recommended removal, reconstructive options, and follow-up.
Schedule a Skin Evaluation
References
Professional Organizations & Clinical Guidelines
- National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Basal Cell Skin Cancer. Current version.
- National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Squamous Cell Skin Cancer. Current version.
- National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Melanoma: Cutaneous. Current version.
- American Academy of Dermatology (AAD). Clinical practice guidelines for basal cell carcinoma, cutaneous squamous cell carcinoma, melanoma, and reconstruction after skin cancer resection.
Scientific Literature
- Kim JYS, Kozlow JH, Mittal B, Moyer J, Olencki T, Rodgers P. Guidelines of care for the management of basal cell carcinoma. Journal of the American Academy of Dermatology. 2018;78(3):540–559. doi:10.1016/j.jaad.2017.10.006. PMID: 29331385.
- Alam M, Armstrong A, Baum C, et al. Guidelines of care for the management of cutaneous squamous cell carcinoma. Journal of the American Academy of Dermatology. 2018;78(3):560–578. doi:10.1016/j.jaad.2017.10.007. PMID: 29331386.
- Swetter SM, Tsao H, Bichakjian CK, et al. Guidelines of care for the management of primary cutaneous melanoma. Journal of the American Academy of Dermatology. 2019;80(1):208–250. doi:10.1016/j.jaad.2018.08.055. PMID: 30392755.
- Nahhas AF, Scarbrough CA, Trotter S. A review of the global guidelines on surgical margins for nonmelanoma skin cancers. Journal of Clinical and Aesthetic Dermatology. 2017;10(4):37–46. PMID: 28458773; PMCID: PMC5404779.
- Chen A, Albertini JG, Bordeaux JS, et al. Evidence-based clinical practice guideline: Reconstruction after skin cancer resection. Journal of the American Academy of Dermatology. 2021;85(2):423–441. doi:10.1016/j.jaad.2021.03.015. PMID: 33931288.
Disclaimer
This information is intended for educational purposes only and does not replace an individualized medical evaluation, biopsy, pathology interpretation, or specialist consultation.
Skin lesions cannot be reliably diagnosed from general website information alone. Treatment recommendations depend on the specific diagnosis, pathology findings, tumor characteristics, location, medical history, and individual patient factors.
Management of melanoma and higher-risk skin cancers may require additional testing, wider surgical excision, lymph-node evaluation, or multidisciplinary care. When appropriate, referral to a dermatologist, surgical oncologist, medical oncologist, or other specialist may be recommended.
Last Updated: September 2026
Medically Reviewed by: Dr. Roberto López Konschot, Board-Certified Plastic Surgeon
