Melanoma Surgery

Melanoma is the most serious type of skin cancer, capable of spreading (metastasising) if not treated early. Early surgical excision with appropriate margins offers the best chance of cure. Dr Schaefer regularly performs melanoma removal procedures at Brisbane Private Hospital, located in Spring Hill.

Melanoma Excision Surgery Overview

1. Diagnosis, Depth, and Margin Planning

After the initial biopsy confirms melanoma, the Breslow thickness (depth in millimetres) and other histological features guide what margin of healthy skin tissue must be removed.

Dr Schaefer will analyse your individual pathology report and plan a removal margin that balances oncologic safety with skin preservation whilst always following evidence-based guidelines

2. The Surgical Removal Procedure

On the day of surgery (often as a day-case, under local or general anaesthesia depending on size/location):

• The melanoma, any residual scar, and the predetermined margin of surrounding skin are carefully excised in one piece
• The tissue is sent immediately for pathological examination
• Dr Schaefer ensures the specimen orientation is clear for the pathologist to assess all margins
  
  

3. Reconstruction & Wound Repair

Once the melanoma is removed, attention turns to wound closure. Dr Schaefer selects the approach best suited to your site and size of removal:

Direct closure / primary closure: for small lesions, the wound edges can generally be stitched directly together.

Skin grafting: a patch of skin (often from a nearby area) transplanted over the excision site.

Local flap repair: nearby tissue is rotated or shifted to cover the defect, usually with good colour and texture match.

Combined or staged reconstructions: for more complex defects, reconstruction may occur in phases for optimal result.

Dr Schaefer’s reconstructive choices are always driven by the goal of restoring appearance and function while minimising visible scarring.

4. Margin Confirmation and Follow-up

The excised tissue is examined under a microscope. If margins are confirmed clear, your melanoma has been fully removed. If any margin is involved (cancer cells extend to the edge), a further excision may be required.

Follow-up includes regular skin checks, monitoring for recurrence, and education on sun protection and skin surveillance.

What to expect: before, during & after

• Before surgery: You’ll meet Dr Schaefer to discuss your pathology report, proposed margins, reconstruction options, risks, and post-operative care. You may need to stop blood-thinning medications for a brief period, as advised.
  
  
• On the day: The surgical team will mark your lesion, confirm plans, answer any last questions, and proceed with excision.
  
  
• Afterwards: You’ll go home with dressings and clear instructions on wound care, pain control, and activity restrictions. You’ll return for suture removal (or graft/flap review) and final pathology discussion.
  
  
• Recovery & scar management: Healing typically spans a few weeks, depending on location and reconstruction method. Dr Schaefer and his team will provide guidance on scar care, protection, and early intervention if healing is delayed.

Risks To Be Aware Of

All surgeries carry risks, and melanoma excision is no exception. Possible complications include:

• Bleeding or haematoma
• Infection or delayed healing
• Wound breakdown or graft/flap failure
• Cosmetic changes, numbness, or altered sensation
• Need for further surgery if margins are not clear
• Anaesthetic-related risks (if general anaesthesia is used)