By Daniel Givens, MD, FACS | Facial Plastic Surgeon & Otolaryngologist | Dubuque, Iowa
When it comes to treating facial skin cancer, patients are often presented with a choice: surgical removal with immediate reconstruction or non-surgical options like stereotactic radiation therapy (SRT). While radiation may seem appealing due to its non-invasive nature, surgery offers better cancer control, fewer treatments, less scarring and lower overall cost.
At Dubuque ENT, we believe in providing treatments that effectively remove the cancer and restore natural appearance and function. Here’s why surgery—with frozen section analysis and immediate reconstruction—remains the gold standard for facial skin cancer treatment.
1. Better Cancer Control and Cure Rates
Particularly when combined with frozen section analysis, surgical excision offers the highest cure rates for non-melanoma skin cancers. Surgical excision with frozen sections has a 5-year cure rate of ~99% for basal cell carcinoma and ~97–98% for squamous cell carcinoma.
Stereotactic Radiation Therapy (SRT) reports lower control rates, around 90–95%, depending on tumor type, size and patient health. While SRT may sound convenient, leaving cancer behind can result in recurrence, requiring more invasive treatment later.
2. Immediate, One-Time Treatment
Surgery is typically performed in a single visit—cancer is removed, and reconstruction is completed on the same day.
In contrast, SRT requires 20–30 treatments over several weeks. Patients must return to the clinic daily or several times weekly, making it time-consuming and disruptive.
Frozen section analysis allows real-time verification that the cancer is fully removed, so there’s no waiting, open wounds or guesswork.
3. Superior Cosmetic Results
When performed by a facial plastic surgeon, surgical excision with immediate reconstruction offers precise incisions, hidden in natural lines or creases, resulting in minimal visible scarring.
Conversely, SRT often causes long-term skin damage, including redness, ulceration, pigment changes and worse cosmetic scarring.
Radiation can also break down surrounding healthy tissue and lead to poor wound healing, especially in the nose, ears or thin-skinned areas.
As your face heals after surgery, we use techniques like flaps or skin grafts to reconstruct the defect for optimal function and appearance carefully.
4. Lower Cost and Fewer Risks
Surgery is more cost-effective than SRT. Despite requiring the skills of both a surgeon and pathologist, it is generally less expensive than a prolonged radiation regimen.
Patients undergoing SRT may experience:
- Radiation dermatitis
- Hair loss
- Increased long-term risk of skin atrophy
- Potential radiation-induced tumors (rare but serious)
Surgery provides definitive removal without subjecting patients to cumulative radiation exposure.
5. Form, Function and Peace of Mind
Our goal with every skin cancer patient is to provide a solution that:
- Removes the cancer completely
- Preserves or restores natural appearance
- Minimizes disruption to daily life
With frozen section analysis, we ensure that margins are clear before reconstruction begins—giving you the confidence that your cancer is gone and your face is already healing.
The Bottom Line
While SRT may be marketed as “non-invasive,” it comes with more treatments, less certainty, worse scarring and higher long-term risks. Facial surgery, when performed by an experienced facial plastic surgeon, is precise, efficient and cosmetically superior.
If you’ve been diagnosed with a facial skin cancer, you deserve a treatment that prioritizes both your health and your appearance.
Contact us today at Dubuque ENT to schedule a consultation. We’re here to help you make the most informed, confident choice for your care.
Daniel Givens, MD, FACS is a board-certified facial plastic surgeon and otolaryngologist in Dubuque, Iowa. He specializes in facial skin cancer treatment, frozen section excision and immediate reconstruction with the goal of achieving natural, long-lasting results.