How Skin Cancer Surgery Differs From Cosmetic Surgery
Worth flagging upfront because patients often arrive at this page from elsewhere on the site and assume the same pathway applies. It doesn’t.
Skin cancer surgery is medical, not cosmetic. That means:
- A standard medical referral from your GP or dermatologist is required, not the AHPRA cosmetic surgery referral pathway.
- The two-consultation requirement and seven-day cooling-off period that apply to cosmetic surgery do not apply here. Skin cancer surgery is treated as standard medical care with the usual clinical urgency.
- Medicare rebates apply to both the consultation and the surgery itself, with private health insurance covering the hospital component.
- Out-of-pocket costs are typically lower than cosmetic procedures, although they vary depending on the complexity of the excision and any reconstructive work needed.
If you’re attending the practice for both a cosmetic concern and a skin cancer concern, those are treated as separate clinical pathways with different paperwork and different fees.
Who Develops Skin Cancer
Anyone can develop skin cancer regardless of skin type, ethnicity, or age. Several factors increase risk:
- Sun exposure. Ultraviolet radiation is the primary cause of basal cell carcinoma and squamous cell carcinoma, and contributes significantly to melanoma. Coastal Australian living amplifies this.
- Fair skin, light eyes, light hair. Less melanin means less natural protection from UV damage.
- Multiple or atypical moles. A higher mole count, or moles that are unusually shaped or sized, increases melanoma risk.
- Family history. Genetics play a meaningful role, particularly for melanoma.
- Outdoor lifestyle. Patterns of high cumulative or intermittent intense sun exposure both matter.
- Previous radiation treatment. Therapeutic radiation (including older treatments for adolescent acne) increases later skin cancer risk in the treated area.
Regular self-examination is the most important early-detection tool. Get to know your own skin, particularly any moles or marks you already have, and book in with your GP or dermatologist if anything changes. Catching skin cancer early changes everything about the outcome.
Types of Skin Lesions
Skin lesions sit in three broad categories: benign, pre-cancerous, and cancerous. Each has different implications for treatment.
Benign lesions. Non-cancerous growths with no potential to develop into cancer. Common examples include moles, skin tags, and cysts. These are generally harmless. They’re sometimes removed for cosmetic reasons or because they’re catching on clothing or causing discomfort.
Pre-cancerous lesions. Early changes that may progress to skin cancer if left untreated. The two most common are actinic keratoses (rough scaly patches caused by sun damage) and squamous cell carcinoma in situ, also called Bowen’s Disease. Treatment options include topical medications, cryotherapy, or surgical removal depending on the lesion and its location.
Cancerous lesions. Malignant growths requiring prompt treatment. The three main types in Australia are basal cell carcinoma, squamous cell carcinoma, and melanoma.
The Three Main Skin Cancers
Basal Cell Carcinoma (BCC)
The most common skin cancer in Australia, and the one with the highest surgical cure rate of the three. BCCs grow slowly and rarely spread to other parts of the body. Left untreated, they can grow downward and erode underlying tissue including bone, which then requires more extensive surgery to manage.
What to look for: pearly or waxy bumps, often flesh-coloured or pink, sometimes with visible blood vessels or a central ulcer. They commonly appear on sun-exposed areas, particularly the face, ears, neck, and hands. They can bleed easily and may not heal properly.
Squamous Cell Carcinoma (SCC)
More aggressive than BCC. SCCs grow faster and are more common in older patients. They typically present as a scaly, quickly growing pink lump that may bleed or ulcerate. They mostly occur on sun-exposed skin (face, lips, ears, backs of hands), and unlike BCC they can spread to lymph nodes and distant sites if neglected. Surgical treatment is usually curative when diagnosed early.
What to look for: firm red nodules or flat lesions with a scaly crusted surface. They sometimes develop from pre-existing actinic keratoses.
Melanoma
The least common of the three, but the most serious. Australia has one of the highest rates of melanoma in the world. Melanoma can develop from an existing mole, or appear as a new spot. Although it’s most common on sun-exposed skin, it can occur anywhere on the body, including areas that rarely see the sun. Diagnosed early, most melanomas can be cured with surgical treatment.
The traditional ABCDE rule remains a useful early-detection guide:
- Asymmetry
- Border irregularity
- Colour variation
- Diameter (historically over 6mm, although smaller melanomas do occur)
- Evolving shape, size, or symptoms
Of these, “Evolving” is increasingly considered the most important. Any mole that’s changing warrants a clinical opinion.
Surgical Treatment
Most skin cancers are best managed surgically. The lesion is excised with a margin of healthy tissue, and the specimen is sent to pathology to confirm complete removal. Other treatments (topical creams, cryotherapy) have a role for certain pre-cancerous and superficial lesions, but for confirmed skin cancers surgery remains the standard.
Lesions on the face or other cosmetically sensitive areas need particular care. The aim is complete oncological clearance, with a reconstructive result that preserves both function (eyelid mobility, lip closure, nasal airway) and appearance.
Reconstruction Following Excision
Once the cancer has been removed, the resulting defect often can’t be closed by simple stitching. Reconstructive techniques are then used to restore the area. The two most common approaches are:
Skin grafts
Skin is taken from another part of the body (usually somewhere with a colour and texture match) and used to cover the defect. The graft relies on new blood vessels growing into it to “take”, and needs careful protection during the early healing phase. The cosmetic result evolves over months as the graft settles and matures.
Skin flaps
Tissue from an area immediately adjacent to the defect is mobilised to fill it. Because the flap brings its own blood supply with it and shares the colour and texture of the surrounding skin, the cosmetic match is generally closer than a graft. Flap reconstruction is often preferred on the face for that reason.
Which approach is appropriate depends on the size and location of the defect. Surrounding tissue characteristics matter too, as does what each technique can realistically achieve in your particular case. We’ll discuss the reconstructive options at consultation, before surgery is scheduled.
After Surgery and Skin Surveillance
Whatever type of skin cancer you’ve had, follow-up matters. Patients who develop one skin cancer have a meaningfully higher risk of developing another, both at the original site and elsewhere.
Surveillance involves three things in combination:
- Self-examination. Regular skin checks at home, looking for new lesions or changes to existing ones.
- Clinical follow-up. Routine appointments with your GP, dermatologist, or surgeon depending on your individual risk profile.
- Lymph node monitoring. For SCC and melanoma in particular, watch for any new lumps in the neck, armpits, or groin and report them to your treating doctor.
Catching recurrence or a new primary skin cancer early changes the treatment options and the outcome.
How Fees Work
Skin cancer surgery is a Medicare-rebated medical service, which means the fee structure is different from cosmetic surgery.
Initial consultation. $275, with a Medicare rebate applicable. Payable on the day of appointment. Same fee at both Sydney clinics.
Surgery in a private hospital. Fees follow the Australian Medical Association schedule. Medicare rebates 75% of the corresponding MBS fee. Private health insurance rebates the remaining 25% of the MBS fee. The gap between the AMA-recommended fee and the MBS fee is the patient’s out-of-pocket cost. Most procedures include follow-up care for the first six weeks. A written estimate is provided when surgery is scheduled.
Surgery in clinic rather than hospital. Some smaller skin cancer procedures are performed at the clinic rather than in hospital. Health insurance doesn’t rebate clinic-based procedures, so the patient out-of-pocket is often larger, but this is usually offset by avoiding the anaesthetist fee and the hospital insurance excess.
Why there’s an out-of-pocket gap at all. Medicare’s MBS fees haven’t kept pace with the cost of providing surgical services since the system was introduced in 1985. The gap between MBS rebates and the AMA-recommended fees is the practical result. The full AMA Schedule is publicly available if you’d like to review it.
For broader fee guidance across all procedures the practice offers, see the Plastic Surgery Prices page.
Public vs Private Pathway
I operate in private hospitals in Sydney’s Eastern Suburbs and on the Northern Beaches. I don’t hold a public hospital appointment. That means I see skin cancer patients who have private health insurance, or who are able to self-fund their hospital admission.
If you don’t have private health insurance and self-funding isn’t an option, your GP can refer you through the public hospital system. The public pathway works well for skin cancer surgery, particularly for non-facial lesions where reconstruction is straightforward. Wait times vary by clinical urgency. Suspected melanoma or aggressive SCC is generally prioritised.
Frequently Asked Questions
Do I need a GP referral for a skin cancer consultation?
Yes. A GP or dermatologist referral is required for the initial consultation. The referral allows Medicare rebates to apply to the consultation and any subsequent procedures. If you have a suspicious lesion that hasn’t been formally diagnosed, your GP can refer you for clinical assessment and biopsy.
Where is skin cancer surgery performed?
Surgery is performed at accredited private hospitals in Sydney’s Eastern Suburbs and on the Northern Beaches. Some smaller procedures are performed at the Bondi Junction or Manly clinic rather than in a hospital theatre. Which setting applies depends on the size and complexity of the excision and the type of reconstruction needed.
What does Medicare cover?
Medicare rebates 75% of the MBS fee for the consultation and the surgery itself. For surgery performed in a private hospital, private health insurance covers the remaining 25% of the MBS fee plus the hospital component. The gap between the MBS fee and the AMA-recommended fee is the patient’s out-of-pocket cost. A written fee estimate is provided when surgery is scheduled.
How is skin cancer surgery different from cosmetic surgery?
Skin cancer surgery is a medical procedure, not cosmetic. The AHPRA cosmetic surgery framework, including the mandatory two-consultation rule and seven-day cooling-off period, does not apply. A standard GP or dermatologist medical referral is required. Medicare rebates apply. The clinical urgency is treated as a medical matter.
What does "reconstruction" actually involve?
Once the skin cancer is removed, the resulting defect often can’t be closed with simple stitching. Reconstruction restores the area using either a skin graft (skin taken from another part of the body) or a skin flap (tissue moved from immediately next to the defect). Which approach applies depends on the size and location of the defect. We’ll discuss the options at your consultation, before surgery is scheduled.
Will I have a scar?
Yes. Any surgical excision leaves a scar. The aim of reconstructive technique is a scar that fades well, sits in a natural skin crease where possible, and minimises functional impact (particularly for lesions near the eyes, lips, or nose). Scar maturation takes 12 to 18 months, with the appearance changing over that period.
How quickly can I have surgery if I've been referred?
Skin cancer surgery is generally booked within two to four weeks of consultation, depending on clinical urgency. Suspected melanoma is prioritised. BCCs are typically less urgent and may be scheduled at a more convenient time for you. The team will discuss timing at your consultation.
To enquire about a skin cancer consultation in Sydney, contact the practice on 1300 437 758 or email [email protected]. A GP or dermatologist referral is required for the initial appointment.
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Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS, MED0001654827). All surgical procedures carry inherent risks, and outcomes vary between individuals. The information on this page is general in nature and does not constitute medical advice. Dr Turner will discuss all relevant risks, alternatives, and expected outcomes during your consultation.
