Tatjana's Story - Facial Reconstruction of the Largest Malignant Melanoma

Tatijana, a ten year old from Russia, presented with a large tumor covering much of her left scalp, brow, and cheek. Dr. Fernau agreed to perform corrective surgery, free of charge (pro bono) to remove the tumor and reconstruct the defect. The surgery included techniques of tissue expansion to stretch the skin, allowing scalp reconstruction, and using aesthetic principles of brow lift, facelift, and blepharoplasty to complete the reconstruction. Three surgeries were performed. The first surgery, with an eight hour operative time, entailed placing tissue expanders with subsequent expansion over a three month period. The second surgery performed three months later, an 18 hour procedure, consisted of first removing the tissue expanders and the entire tumor. Dr. Fernau reconstructed the defect with scalp flaps from the expanded tissue and using aesthetic techniques, performed a left brow lift and left facelift. The third surgery performed one month later, a two hour procedure, constituted a left blepharoplasty to complete the reconstruction. After the surgery, pathology revealed the tumor was a malignant melanoma, the world's largest at that time. Postoperatively, CT Scans, MRIs, and PET scans revealed no evidence of disease. Fourteen years later she remains free of this devastating cancer!