Skin Cancer Assessment & Removal in Singapore
Specialist plastic surgical care from biopsy through to reconstruction
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. If you have noticed a lesion that is new, growing, bleeding, itching, or simply looks different from others on your skin, an early assessment is the right first step.
Types of Skin Cancer We Manage
The three most common forms of skin cancer seen in Singapore are:
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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.
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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.
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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).
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Less common skin malignancies, including Merkel cell carcinoma 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:
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A lesion that is new and has not resolved after four to six weeks
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A mole or pigmented lesion that is growing, changing shape, or developing irregular borders
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A lesion that bleeds spontaneously or with minor trauma
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A sore or ulcer on the skin that does not heal
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A pearly or translucent nodule, particularly on the face
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A rough, scaly patch that persists despite moisturising
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Early assessment DOES NOT commit you to treatment. It simply establishes whether the lesion is something that needs to be watched, biopsied, or removed.
The Role of a Plastic Surgeon in Skin Cancer Care
Surgical excision is the primary treatment for most skin cancers. The involvement of a plastic surgeon matters for two reasons.
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First, excision must achieve clear margins - the cancer must be removed completely, with a rim of normal tissue around it. The required margin width depends on the tumour type, size, and location. Inadequate excision is the leading cause of local recurrence.
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Second, once the tumour is removed, the resulting defect must be closed. On the face, scalp, ears, and hands, straightforward closure is not always possible. Reconstruction may require local tissue rearrangement, a skin flap, or a skin graft. Dr Ng is trained in the full range of reconstructive options, meaning that assessment, excision, and reconstruction are managed by the same surgeon throughout.
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For cases requiring more extensive reconstruction (for example, following large facial excisions), continuity of care is available through ZNG Plastic Surgery, Dr Ng's main reconstructive practice.
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 one to two weeks, after which a clear treatment plan is discussed.
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(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 sent for formal margin analysis to ensure clearance.
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(4) Reconstruction and closure: The defect is closed with the simplest technique that achieves a good functional and cosmetic result. This may range from direct closure to a local flap (tissue rearrangement, think of it like origami) depending on the size and location.
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(5) Follow-up: Structured follow-up is arranged to review histology results, assess wound healing, and discuss any further management and surveillance checks required.
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Most cases are managed in a clinic or day surgery setting without hospital admission.
A Note on Skin Cancer in Singapore
Skin cancer incidence in Singapore is much lower than in Australia or northern Europe, but it is not rare and most likely under-diagnosed. Fair-skinned individuals, those with significant cumulative sun exposure, and people with a personal or family history of skin cancer carry a higher baseline risk.
Expatriates from high-incidence countries who are accustomed to routine skin checks at home may find the pathway to specialist assessment 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.
Pricing
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
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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.
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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.
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5. Is skin cancer treatment covered by insurance?
Skin cancer excision and reconstruction are generally claimable under medical insurance policies. We recommend checking your policy terms and can provide documentation to support your claim.
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.
To arrange an assessment, contact us via WhatsApp.
Same-day appointments are available subject to scheduling.
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