Stay tuned for more updates on Giribaldi.

We’ll be back to our normal format next week, but this week I wanted to give you some follow up on Manuel and, with summer coming, take this opportunity to give you advice on how to protect yourself so you don’t develop such a skin cancer.

First of all, for those of you who missed it, last week a whole bunch of kind hearted people helped a 70-year-old Mexican artist get rid of a large skin cancer which had eaten away the center of his face!

The surgery was performed at the Laguna Hills Surgery Center, and all services for his surgery were donated by Orange County Plastic Surgery, the Surgery Center, its staff, Dr. Kevin Becker the anesthesiologist and surgery center medical director, and the pathologist, Dr. Allan Rushovich.

With Dr. Rushovich’s help, we were able to determine the extent of the tumor and to remove all of it. This entailed removing what was left of his nose and about half of his right cheek. I was able to close the central defect with a flap from his forehead, rotating it 180 degrees to cover the area that had been occupied by his nose. The flap is 100 % viable and he is making a remarkable recovery.

There were a few days when he was down, but as the swelling begins to go away Manuel realizes that he will eventually look much better than he did before his cancer was removed.

When a flap is rotated 180 degrees like this a pucker is created at the point where the skin is turned on itself. In this case, the pucker is located just below the right eyebrow medially. This temporary pucker is necessary because it contains the blood supply to the flap and cannot be transected until the flap gains new blood supply from the area in which it was placed.

In a month or two Manuel will return to have this pucker resected and he should be ready for more photographs. This is what Manuel looked like prior to going in for his surgery. The pink on his right cheek was also a tumor and had to be resected.

(Actual patient of Dr. Bunkis)

Thanks to all of you who helped and for the many of you who send us encouraging words.

Summer is around the corner and we should all be cautious to minimize sun damage to our skin. Excessive exposure to the suns UV rays is the cause of skin cancers.

It has been shown conclusively that skin cancers occur more frequently in areas that enjoy more sunny weather (definitely more common in California, Texas and Florida than in Washington state or Minnesota). It occurs more commonly in fair skinned people and definitely more common in people who have spent more time in the sun! But that does not mean that we should avoid the beautiful out of doors we have here in California! Just do whatever you can to protect your skin from exposure.

Sun block should be applied to all exposed skin and a hat should be worn whenever possible to keep excessive rays of sunshine off our face. Get a good sun block that you like. Look at the SPF factor. In general, the higher the SPF factor, the longer the sun block will protect your skin. A 15 may have to be reapplied every hour to be effective, while a 45 will protect you for four hours.

And if you hate the white look, it is possible to get a very effective spray tan before you go outside – and then put sun block over it! The best place to do this in Orange County is one of the five Unique Tan Bronzing Boutiques (http://www.uniquetan.com). If you have a choice, plan your outdoor activities in the early morning or later in the afternoon instead of mid day when the sun’s rays are most intense.

Manuel had a basal cell carcinoma, by far the most common type of skin cancer. A basal cell carcinoma will continue to grow and grow, eating the flesh locally but cells from this cancer do not metastasize. If not treated, this tumor can create local havoc but cells do not break away and travel to the brain, lungs, liver or lymph nodes, and they can with the other two skin cancers.

Manuel got into the trouble he did because his cancer was not treated adequately as he had it for 27 years.

In this country, it is possible to see a case like this in some of the more remote areas, but it is very rare because these cancers do not grow quickly and most people would have enough sense to get it treated. The other two types of skin cancers, squamous cell carcinomas and melanomas carry a more serious threat as they can spread to other parts of the body.

Squamous cell carcinomas usually occur in older folks who have been in the sun a lot (for example, older fishermen, golfers or tennis players) but melanoma’s can strike the young as well as the old and can be very deadly if not caught early.

Melanomas frequently arise from moles.  If you have a lot of moles on your body, you should see a dermatologist at least once a year for a total body skin check. Dr. Daniel Di Cesare of Orange Coast Dermatology is an excellent dermatologist and we would recommend him highly.  He works our of our Orange County Plastic Surgery office and can be reached at 949-888-8500.

So look beautiful this summer, but be wise. Use sun block, wear a hat and sunglasses, and do see a good dermatologist once a year if you have a lot of moles or if you have had a cancerous or precancerous skin lesion in the past.

949-888-8500 | 30212 Tomas Ste. 275, Rancho Santa Margarita, CA 92688 | www.ocps.com