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Melanoma - Skin Cancer
The Most Dangerous Skin Cancer

Dr. Costanzo has extensive Reconstructive Plastic Surgery experience following Skin Cancer and Trauma.  Come to Thousand Oaks for your Melanoma, Lentigo Maligna or Desmoplastic Melanoma Treatment or Reconstructive procedures performed by  Dr. Costanzo, servicing all of Southern California including Thousand Oaks, Beverly Hills, Los Angeles, Encino, Woodland Hills, Tarzana, Sherman Oaks, Calabasas, Chatsworth, Granada Hills, Ventura, Agoura, Westlake Village, Moorpark, Simi Valley, Santa Barbara, Oxnard, San Diego, Riverside County and Orange County


Example of MelanomaSkin Cancer Example of MelanomaSkin Cancer
Example of MelanomaSkin CancerExample of MelanomaSkin Cancer

Top / Left to Right:   Superficial Spreading Type - Superficial Spreading Type 
Bottom / Left to Right:   Lentigo Maligna Type / Regression of Melanoma

Types of Melanoma

Superficial Spreading

70% of all Melanomas

Spreads along surface, before invading deeper

Irregular shaped, flat or elevated, multiple colors

Trunk, legs and upper back - most commonly involved areas

Lentigo Maligna

Very early Melanoma, with a good prognosis

Older age group

Face, upper trunk and arms


Black nodule, usually invading deeply


Found on the palms of hands, soles of the feet and under the nails


Lacks pigment and can be a very aggressive Melanoma


Highest in fair skin individuals & those with sun exposure


Pathological Classification by depth of penetration into the skin

Clark's Level of Penetration

Level I - confined to Epidermis

Level II - penetrates the upper dermis or Papillary layer

Level III - fills the upper dermis or Papillary layer

Level IV - penetrates the lower dermis or Reticular layer

Level V - invades deeply into the fat

Breslow's Classification - Based Depth of Invasion into the Skin

0.75mm or less

0.76mm to 1.50mm

1.51mm to 4.0mm

4.0mm or greater

0.75mm or less = almost 100% survival for 10 years

Greater than 3.0mm = Poor Prognosis


Surgical excision - wide, based on the depth of penetration

1-2-3 Rule

Remove a 1cm cuff of normal tissue on all sides of the Melanoma for penetration 1mm or less

Remove a 2cm cuff of normal tissue on all sides of the Melanoma for penetration 2mm or less

Remove a 3cm cuff of normal tissue on all sides of the Melanoma for penetration greater than 2mm

Sentinel Lymph Node Removal or Lymphadenectomy

Biopsy of lymph node(s) - First dye is injected into the skin surrounding the Melanoma to find the lymph node drainage. Then the 1st node in the chain is removed and analyzed

Lymphadenectomy (removal of all lymph nodes in the area) is done if there is involvement of the Sentinel node(s)

Radiation Therapy - generally done to relieve tumor symptoms

Chemotherapy - systemic or local - used to control tumor spread

Biological or Immunotherapy

Agents used to stimulate the Immune System

Block blood vessel formation

Directly attack the tumor cells

BCG ( Bacillus-Calmette-Guerin, TB strain ) or Vaccine

Interleukin 2 ( Lymphokines )

Basal Cell Carcinoma - Squamous Cell Carcinoma - Melanoma


Reconstructive Plastic Surgeon Dr Costanzo, Thousand Oaks
805 / 373-9919

Skin Cancer Removal and Reconstruction by Dr. Costanzo of Thousand Oaks, a Cosmetic
and Plastic Reconstructive Surgeon, serving men and women in California, Beverly Hills,
Los Angeles, Encino, Sherman Oaks, Chatsworth, Woodland Hills, Tarzana, Granada Hills,
West Hills, Malibu, Calabasas, Agoura, Oxnard, Simi Valley, Moorpark, Camarillo, Santa
Barbara, Los Angeles County, Ventura County and Santa Barbara County.  Dr. Costanzo
accepts insurance for his consultations.

© Copyright 2009, Dr. Costanzo, All Rights Reserved
Disclaimer - The information about Cosmetic surgery contained in this web site is for
informational purposes only and does not constitute medical advice.
Call to schedule an appointment with Thousand Oaks Plastic surgeon Dr. Costanzo,
2190 Lynn Road, Suite 380, Thousand Oaks, CA 91360