You only get one skin in your lifetime so treat it kindly. Actually the skin is a very complex organ that is constantly turning over with new cells. There is much that can be done to enhance the quality and the longevity of your skin. Avoid excessive exposure to the sun. When outdoors, even on a cloudy day, you can still get radiation exposure. We recommend using a sun screen (SPF #30) on exposed areas. Reapply as often as needed. Also note that tanning beds are not without risk and can cause permanent skin damage, and can increase your risks of skin cancer. Smoking also adversely affects the skin. If you do smoke - for the sake of your lungs, heart, and skin - please stop. Some people are born with a noticeable significant skin lesion - birth mark, mole, or hemangioma, but most often these and other blemishes develop slowly over time. Most of these are harmless. However, over the years irritated skin and moles can turn into cancer. There is clearly a very significant genetic factor in developing skin cancers. When there is a family history of skin cancer you must be extra careful and extra vigilant. Some people are born with a noticeable significant skin lesion - birth mark, mole, or hemangioma, but most often these and other blemishes develop slowly over time. Most of these are harmless. However, over the years irritated skin and moles can turn into cancer. There is clearly a very significant genetic factor in developing skin cancers. When there is a family history of skin cancer you must be extra careful and extra vigilant.

Skin cancers do not develop overnight. Generally speaking there are signs and symptoms which progress over a period of weeks, months, or even years. A change in the size, shape, color, or thickness of a skin blemish or mole may be significant (see the ABCDE's of Melanoma below). Symptoms of itching, burning, and especially bleeding can indicate a problem. When you have a concern you should always seek qualified medical evaluation. If others in your family have had skin cancer, or if you have had one in the past, you should have regular checkups by someone specially trained to recognize cancer.

You can reduce the risk of developing skin cancer by avoiding excessive exposure to the sun and other forms of radiation, and by avoiding tobacco use, both smoking and chewing. However, even some people who have a dark complexion, who avoid the sun, and who have never smoked still have problems. These individuals may have inherited a predisposition to getting skin cancers. Unfortunately we are seeing skin cancers in an ever younger population. Many young men and young women in their early twenties have already required treatment for skin cancers.

The most important thing to remember about skin cancers, however, is that they are almost always curable when detected early - hence the importance of skin cancer screens. Even patients with the dreaded malignant melanoma can usually be cured if the cancer is found in its earliest stages.

1. Benign (non-cancerous) Lesions: These can be removed for several reasons.
   • To prevent irritation from clothing
   • To prevent spreading as in the case of warts
   • To improve appearance.
2. Malignant (cancerous) Lesions: These must be removed.

One patient out of every eight who developes melanoma dies from this very dangerous skin cancer. Early detection can in most instances provide a cure. The key, especially with individuals who have a family history of melanoma or who have had previous pre-melanomas (dysplastic moles) removed its to be follow very, very closely.

All patients should be aware of the ABCDE’s of Melanoma:

A – Asymmetry (moles are are not symmetrical when comparing one half to the other)
B – Border irregularities (moles with edges that are not even).
C – Color (moles with dark or especially multiple colors
D – Diameter (moles larger than a pencil eraser)
E – Elevation (raised moles) or Evolution (moles that are changing)

Not all moles that meet one or more of these criteria are automatically dangerous. However when moles meet these conditions they should be checked out by someone familiar with skin cancer, especially melanomas, and the appropriate treatment.

Plastic Surgery Associates of Tidewater has offered photographic mapping of skin to any patient. This is an especially valuable tool. As the only medical practice in southeastern Viriginia equipped with the FotoFinder® system we can offer patients the state of the art surveillance of their skin.

The fotofinder combines the capability of high resolution digital photographs, dermascopy, and computerized mapping to detect the presence of new moles or changes in existing moles. This is a tool that helps your physician find, evaluation and track changes in your skin. The ultimate decision, of course, whether to remove any lesion is up to you after receiving the recommendation of you PSAT physician.

If you or someone in your family has had skin cancer, especially melanoma, please contact us to set up an appointment for a screening examination and possible digital photographic mapping and/or dermascopy. Doing so could save someone’s life. Many patients come to our offices for evaluation of old scars resulting from accidents, infection (e.g. acne), or previous surgery. There is nothing which can be done to completely remove an old scar. However, by using sophisticated plastic surgical techniques much can usually be done to reduce the disfigurement. In some cases this will require a series of revisions and the application of multiple techniques. With time everyone's skin ages. Sun exposure, smoking, weight gain or loss, and hereditary factors play important roles in skin changes over one's lifetime. For this reason patient's skin ages at different rates. We see some patients in their twilight years with naturally smooth, wrinkle and blemish free skin. Others in their early years look like they are overtaking grandma. Even with this wide variation there are some general observations and recommendations we can make to enhance both the short and long-term quality of your skin.

• If you smoke - STOP
• Avoid excessive sun exposure
• Use good quality skin care products and use them regularly
• Avail yourself of the latest techniques in skin rejuvenation

The term "chemical peel" is unfortunately associated with visions of paying thousands of dollars, being secluded for weeks at a time, and a high risk of complications. Well, things have changed - welcome to the 90s. Many patients in their 20s and early 30s, and even teenagers with mild scarring from acne, are realizing the benefits of Refreshing (glycolic acid) Peels. By using a series of mild peels carried out in the office we can improve and help maintain the texture of your skin without interrupting your lifestyle. With these peels there is no "down time". If a somewhat deeper refreshment of the skin is needed other state of the art peels are also available with minimal risk, but significant benefits.

When the aging process has produced fine wrinkling, when "age spots" seem to be growing like weeds, or when acne scars are more prominent, we recommend the latest techniques in facial rejuvenation - Laser Resurfacing. The laser is the most precise, controlled and predictable tool available to provide dramatic and long lasting improvement in the quality and texture of your skin. Although much more involved, and more costly than the peels noted above, laser resurfacing is rapidly becoming the most popular procedure sought by patients, even in their 30's to turn the tide against facial aging. Localized excess fat is one of the most common naturally occurring deformities adversely affecting facial and other areas of body contour. Liposuction is a safe and highly effective way to restore proportions in most patients. The selective removal of excess fat can be carried out alone or in conjunction with other procedures. Gravity keeps our feet on the ground. It also makes our skin sag. Weight gain and loss can also accelerate this process. As we get older, the techniques of skin resurfacing unfortunately are less effective in tightening up the baggy skin that collects around the eyes, under the jaw line, and on the cheeks and neck. In these instances mini or full Face Lift procedures provide the most dramatic and long lasting results. We have cared for patients from their teens to their eighties who have benefited tremendously from facelift techniques. You may be surprised to know that patients seeking this technique for facial rejuvenation are most commonly in the 40-55 year age group.