Skin Cancer Assessment, Excision & Reconstruction in Singapore

Outpatient Evaluation, Definitive Excision, and Immediate Cosmetic Reconstruction. Avoid General Anesthesia and Unnecessary Hospital Delays.

A new or changing skin lesion can be unsettling. Most turn out to be benign, but some require prompt attention. At Doctor Stitch, assessment of suspicious lesions is led by our plastic surgeon Dr Ng Zhi Yang, who has specific training in the surgical management of skin cancer according to the UK NICE and BAD guidelines. By managing both the tumour clearance and the structural reconstruction within the same procedure, we prioritise complete cancer removal while actively preserving natural contours and minimising long-term visible scarring.

Types of Skin Cancer We Manage

The three most common forms of skin cancer seen in Singapore are:

Basal cell carcinoma (BCC) is the most frequently encountered skin cancer globally. It grows slowly and rarely spreads but can cause local tissue destruction if left untreated. It most commonly appears on sun-exposed areas such as the face, ears, scalp, and neck.

Squamous cell carcinoma (SCC) arises from the outer layers of the skin and has a greater potential to spread than BCC if not treated promptly. It may present as a rough, scaly patch, a firm nodule, or an ulcer that does not heal, especially in chronic wounds such as burns.

Melanoma is less common but the most serious of the three. It can arise from an existing mole or appear as a new pigmented lesion, and early detection is critical for survival outcomes. Any mole that is Asymmetric, has irregular Borders, contains multiple Colours, is growing in size (Diameter and Elevation), or is causing symptoms warrants urgent review (ABCDE).

Less common skin malignancies, including Merkel cell carcinoma, Marjolin's ulcer and dermatofibrosarcoma protuberans (DFSP), are also managed where appropriate.

Warning Signs to Look Out For

Seek an early assessment if you notice any of the following:

A lesion that is new and has not resolved after four to six weeks
A mole or pigmented lesion that is growing, changing shape, or developing irregular borders
A lesion that bleeds spontaneously or with minor trauma
A sore or ulcer on the skin that does not heal
A pearly or translucent nodule, particularly on the face
A rough, scaly patch that persists despite moisturising

Early assessment DOES NOT commit you to treatment. It simply establishes whether the lesion is something that needs to be watched, biopsied, or removed.

Same day skin cancer assessment and treatment by a plastic surgeon - Doctor Stitch, Singapore

Same day assessment and treatment of possible skin cancer - Doctor Stitch, Singapore

The Role of a Plastic Surgeon in Skin Cancer Care

Surgical excision remains the primary definitive treatment for cutaneous malignancies. Our approach addresses the two distinct surgical phases:

1. Margin Clearance

Inadequate excision is the primary driver of local recurrence.

The Protocol: The lesion is excised under local anesthesia with precise, predetermined margins of normal surrounding tissue as measured under magnification (at least 3x). This is based strictly on tumour type, depth, and anatomical location.
Margin Analysis: Every specimen is structurally oriented and sent for formal histological margin mapping to verify complete eradication by a pathologist.

2. Plastic Surgical Reconstruction

When tumours are removed from delicate aesthetic zones such as the eyelids, nose, ears, lips, or hands, closing the skin in a straight line is often anatomically impossible or causes facial distortion.

The Modalities: Dr Ng utilises advanced local tissue rearrangements. This ranges from primary tension-free closures to local flaps and skin grafts.
The Continuity: For extensive or complex defects requiring advanced surgical oncology management (including sentinel lymph node biopsy and/or lymph node dissection), seamless continuity of care is provided by Dr Ng who manages the complete surgical pathway through ZNG Plastic Surgery.

Dr Ng is trained in the full range of reconstructive options, meaning that assessment, excision, and reconstruction are managed by the same surgeon throughout, with cosmesis and function in mind. This scope of practice, combining plastic surgical reconstruction with oncological skin surgery including lymph node procedures, is uncommon in Singapore's private sector. Therefore, the involvement of a plastic surgeon matters for an optimal outcome in skin cancer.

What Does Assessment and Treatment Involve?

(1) Assessment: A focused clinical examination of the lesion is performed. Where the diagnosis is uncertain, a biopsy is arranged to obtain a tissue diagnosis before definitive treatment is planned.

(2) Biopsy: A small sample of tissue is taken under local anaesthesia and sent for histological analysis. Results are typically available within a few days, after which a clear treatment plan is discussed.

(3) Wide local excision: Once the diagnosis is confirmed, the lesion is excised under local anaesthesia with an appropriate margin of normal surrounding tissue. The specimen is oriented and sent for formal margin analysis to ensure clearance.

(4) Reconstruction and closure: The defect is closed with the simplest technique that achieves a good functional and cosmetic result. This may range from primary closure (stitching it up directly) to a skin graft (using skin taken from elsewhere, think of it as "cut and paste") or a local flap (tissue rearrangement, like origami) depending on the defect size and location.

(5) Follow-up: Structured follow-up is arranged to review histology results, assess wound healing, and discuss any further management and surveillance checks required.

Majority of cases are managed in a clinic or day surgery setting without hospital admission.

A Note on Skin Cancer in Singapore

Overall, the incidence of skin cancer in Singapore is much lower than in Australia and the UK where Dr Ng trained, but it is not rare and in all likelihood, under-diagnosed. Fair-skinned individuals, those with significant cumulative sun exposure and a history of sun burns in childhood, and people with a personal or family history of skin cancer will all carry a higher baseline risk.

With an increasingly international population here in Singapore, expatriates from high-incidence countries who are accustomed to routine skin checks at home may find the pathway to specialist assessment and management for skin cancer less clear in Singapore. We see a significant number of patients in this category, and early assessment is always appropriate where there is clinical concern.

Skin cancer same day assessment & treatment in Singapore by a plastic surgeon 1 - Doctor Stitch

Skin cancer same day assessment & treatment in Singapore by a plastic surgeon 2 - Doctor Stitch

Pricing

Performing the majority of biopsy, excision, and reconstructive steps within a specialised clinic procedure room rather than booking a major hospital operating theatre removes hospital related costs. This results in a direct financial saving of approximately 20% to 30% on your total medical bill. There is no difference in clinical outcomes.

Pricing varies depending on the number, size, location, and complexity of the lesion in accordance with Singapore MOH Table of Surgical Procedure (TOSP) fees. Consultation and follow-up, as well as medications and further tests (such as X-ray and/or CT, MRI), if necessary, are charged separately. A clear cost estimate is provided before any treatment is initiated. Medisave and insurance are almost always claimable for skin cancer management.

Frequently Asked Questions

1. Do I need a referral to be seen?
No referral is required. You can contact us directly via WhatsApp. Sending a photograph of the lesion in advance allows Dr Ng to give a preliminary view on urgency before your appointment.

2. How quickly can I be seen?

We aim to offer prompt assessment for lesions causing concern. Contact us via WhatsApp to discuss availability.

3. Will I need surgery at the first appointment?
Not necessarily. If the diagnosis is clear and same-day excision is appropriate, this can be arranged at the initial visit. Where a biopsy is needed first to confirm the diagnosis, excision is planned once results are available.

4. What if the excision leaves a large defect?
Reconstruction is planned as part of the overall treatment. For straightforward closures, this is performed at the same sitting as excision. For larger or more complex defects, particularly on the face or limbs, reconstruction is managed by Dr Ng through ZNG Plastic Surgery.

5. Is skin cancer treatment covered by insurance?

Skin cancer biopsies, excision and reconstructive surgeries are medically necessary procedures. We provide structured medical reports, itemised fee breakdowns, and standard insurance memo documentation to support your corporate or international health insurance claims (e.g., Cigna, Bupa, Allianz, AIA Executive). Procedures may also be eligible for partial Medisave claims under standard MOH guidelines.

6. What happens to the removed tissue?
All excised tissue will be sent for formal histological analysis, including margin assessment. You will be informed of the results and their implications at your follow-up appointment.

References

NICE, SIGN and ESMO Melanoma Guidelines
Nasr I, McGrath EJ, Harwood CA, Botting J, Buckley P, Budny PG, Fairbrother P, Fife K, Gupta G, Hashme M, Hoey S, Lear JT, Mallipeddi R, Mallon E, Motley RJ, Newlands C, Newman J, Pynn EV, Shroff N, Slater DN, Exton LS, Mohd Mustapa MF, Ezejimofor MC; British Association of Dermatologists’ Clinical Standards Unit. British Association of Dermatologists guidelines for the management of adults with basal cell carcinoma 2021. Br J Dermatol. 2021 Nov;185(5):899-920. doi: 10.1111/bjd.20524. Epub 2021 Aug 13. Erratum in: Br J Dermatol. 2022 Mar;186(3):597. doi: 10.1111/bjd.21040. PMID: 34050920.
Keohane SG, Botting J, Budny PG, Dolan OM, Fife K, Harwood CA, Mallipeddi R, Marsden JR, Motley RJ, Newlands C, Proby C, Rembielak A, Slater DN, Smithson JA, Buckley P, Fairbrother P, Hashme M, Mohd Mustapa MF, Exton LS; British Association of Dermatologists’ Clinical Standards Unit. British Association of Dermatologists guidelines for the management of people with cutaneous squamous cell carcinoma 2020. Br J Dermatol. 2021 Mar;184(3):401-414. doi: 10.1111/bjd.19621. Epub 2021 Jan 18. Erratum in: Br J Dermatol. 2021 Sep;185(3):686. doi: 10.1111/bjd.20649. Erratum in: Br J Dermatol. 2022 Mar;186(3):596-597. doi: 10.1111/bjd.21039. PMID: 33150585.
Elsensohn A. Directions in Nonmelanocytic Tumors: Squamous Cell Carcinoma and Merkel Cell Carcinoma. Dermatol Clin. 2026 Apr;44(2):221-231. doi: 10.1016/j.det.2026.01.008. Epub 2026 Feb 16. PMID: 41951324.
Tobin C, Sanger JR. Marjolin's Ulcers: A Case Series and Literature Review. Wounds. 2014 Sep;26(8):248-54. PMID: 25860780.
Zhou MH, Stirrat TP, Alam M, Bordeaux JS, Brewer JD, Minkis K, Nouri K, Remotti F, Matushansky I, Lipner SR. Dermatofibrosarcoma protuberans: A clinical review of diagnosis and management. J Am Acad Dermatol. 2026 Feb 23:S0190-9622(26)00290-2. doi: 10.1016/j.jaad.2026.02.072. Epub ahead of print. PMID: 41740895.
Shuber E, Abdulhussein D, Sinclair P, Kadhum M. Who Should Carry Out Skin Cancer Excisions? A Systematic Review. J Cutan Aesthet Surg. 2019 Jul-Sep;12(3):153-157. doi: 10.4103/JCAS.JCAS_174_18. PMID: 31619886; PMCID: PMC6785968.
Oh CC, Jin A, Koh WP. Trends of cutaneous basal cell carcinoma, squamous cell carcinoma, and melanoma among the Chinese, Malays, and Indians in Singapore from 1968-2016. JAAD Int. 2021 Jun 30;4:39-45. doi: 10.1016/j.jdin.2021.05.006. PMID: 34409390; PMCID: PMC8361884.

To arrange an assessment, contact us via WhatsApp.

Same-day appointments are available subject to scheduling.

Back to Minor Surgery overview

Concerned about scarring after skin cancer treatment? See our scar revision page

Where complex reconstructive surgery is required, care may continue under Dr Ng Zhi Yang via ZNG Plastic Surgery