Basal Cell Carcinoma Treatment in Edinburgh
Basal cell carcinoma treatment at Waterfront Private Hospital is a consultant-led pathway in Edinburgh — assessment, surgical excision, and reconstruction, where the lesion site requires it, all performed by the same consultant. Care is delivered by Mr Ben Aldridge, the UK’s only consultant dual-qualified in dermatology and plastic surgery, with a PhD in skin lesion diagnostics, and by Mr Kazem Nassar, consultant plastic and reconstructive surgeon. Both are on the GMC Specialist Register and sit on the South East Scotland Melanoma MDT. Most basal cell carcinomas are managed surgically; complex or recurrent cases are discussed at MDT.
Contents
Basal cancer cell removal
I had a surgical incision to remove a Basal Cell Carcinoma. It was a brilliant experience and result. The patient care and after surgery attention was outstanding. I am so grateful.
Sandy Alexander
Nov 2024
Overview
- Consultants: Mr Ben Aldridge or Mr Kazem Nassar, both on the GMC Specialist Register.
- Pathway: consultation, surgical excision under local anaesthetic, reconstruction where indicated, histology confirmation, and follow-up — all at Waterfront.
- Anaesthetic: local anaesthetic for most cases; general anaesthesia where a larger reconstruction is required.
- Hospital stay: day case for the great majority of cases.
- Surgical excision: from £1,495.
- Surgical excision with reconstruction: from £2,195. Final pricing is set after assessment.
- Time from booking to consultation: typically 1-2 weeks.
How basal cell carcinoma is diagnosed and treated at Waterfront
Basal cell carcinoma is the most common skin cancer in the UK. It develops from cells at the base of the epidermis and most commonly appears on sun-exposed skin — the face, ears, scalp, neck, and the backs of the hands. Typical presentations include a pearly or translucent nodule, a non-healing sore, a slowly enlarging patch, or a scaly red area that recurs.
Diagnosis is made by consultant assessment supported by dermoscopy. Where clinical and dermoscopic findings are characteristic, surgical excision is planned with appropriate margins. Where the diagnosis is less certain, a biopsy is taken first, with the wider excision arranged after histology confirms the diagnosis.
Surgical excision is performed at Waterfront under local anaesthetic in most cases. Where the lesion is on the face, ears, scalp, or another cosmetically sensitive site, reconstruction with a skin flap or graft is planned in the same procedure by the consultant performing the excision. Histology of the specimen confirms complete excision and identifies the basal cell carcinoma subtype.
Most basal cell carcinomas are managed surgically without MDT discussion. Complex, recurrent, or high-risk cases — for example morphoeic subtype, ill-defined edges, or anatomically sensitive sites where margins are difficult — are discussed at MDT, and where appropriate may be referred onward for Mohs micrographic surgery in a specialist centre.
What to expect from basal cell carcinoma treatment
The great majority of basal cell carcinomas are managed in a single procedure: surgical excision with planned margins, and reconstruction in the same sitting where needed. Histology after surgery confirms whether the excision is complete.
Basal cell carcinoma rarely metastasises. The principal goals of treatment are complete local excision and a final scar that is appropriate to the site. Outcomes after complete excision are very good, with low recurrence rates for the majority of lesions.
Where reconstruction is needed, the technique is selected by the consultant during the consultation, based on the site, size, and shape of the expected defect. The consultant performing the excision plans and carries out the reconstruction, so the surgical plan is coherent.
When to seek a basal cell carcinoma assessment
Patients commonly book a basal cell carcinoma assessment when they have noticed one of the following.
- A pearly or translucent nodule that has appeared on sun-exposed skin.
- A sore or scab on the face, ears, or scalp that has not healed within a few weeks.
- A red, scaly patch that recurs in the same place despite emollients.
- A slowly enlarging patch of skin that looks different from the surrounding area.
- A history of significant sun exposure, repeated sunburns, or previous skin cancer.
- A new lesion in a patient who is immunosuppressed.
Most skin lesions assessed by a consultant are benign. Where a basal cell carcinoma is suspected, the assessment is the first step on a clear pathway to definitive treatment.
Risks and considerations
Surgical excision of basal cell carcinoma carries the same general risks as any minor surgical procedure — bruising, infection, scarring, and altered sensation around the wound. The site of the lesion influences the appearance of the final scar; your consultant will discuss this in detail before surgery.
Margin reassessment is occasionally needed. If histology shows that the basal cell carcinoma extends to the edge of the initial excision, a further excision is required to achieve clear margins. This is part of standard basal cell carcinoma management.
Recurrence is uncommon after complete excision but possible, particularly in morphoeic or ill-defined lesions, lesions on high-risk sites, or where margins were narrow. Patients with a personal history of basal cell carcinoma are at higher risk of developing further basal cell carcinomas elsewhere over time, and are commonly advised to remain alert to new lesions and to seek review if any develop.
Some basal cell carcinomas — particularly aggressive subtypes on anatomically complex sites — are best treated by Mohs micrographic surgery, which is not delivered at Waterfront. In those cases your consultant will recommend referral to a specialist centre for Mohs surgery.
Aftercare and follow-up
After surgical excision at Waterfront, a nurse reviews the wound at one week, and more often if needed in the early healing period. Your consultant reviews you at around six months once the result has settled. Between then, your consultant is always available — if anything concerns you, they will respond directly and arrange to see you as soon as needed.
Long-term follow-up after complete excision of a basal cell carcinoma is usually not required on a scheduled basis. Patients are advised to remain alert to new lesions developing elsewhere on the skin and to seek a review if any appear. Where a patient has multiple basal cell carcinomas, significant sun damage, or other risk factors, ongoing surveillance can be arranged.
What does basal cell carcinoma treatment cost?
Pricing depends on the size and site of the lesion and on whether reconstruction is needed.
- Consultation with a consultant: £200.
- Surgical excision: from £1,495.
- Surgical excision with reconstruction: from £2,195. Final pricing is set after consultation, based on the lesion site, the size of the excision, and the type of reconstruction required.
Each price covers the surgeon’s fee, the anaesthetist’s fee where applicable, the hospital and theatre fee at Waterfront Private Hospital, histology, and post-operative reviews until you are fully discharged. The full price for your individual case is confirmed in writing after consultation, before the procedure is booked.
Our basal cell carcinoma consultants
Basal cell carcinoma at Waterfront is treated by Mr Ben Aldridge — the UK’s only consultant dual-qualified in dermatology and plastic surgery, with a PhD in skin lesion diagnostics, co-author of national skin cancer guidelines, and chair of the South East Scotland Melanoma Multidisciplinary Team — and by Mr Kazem Nassar, consultant plastic and reconstructive surgeon. Both consultants are on the GMC Specialist Register and sit on the South East Scotland Melanoma MDT. Both perform the full spectrum of basal cell carcinoma surgery, including reconstruction.
Frequently asked questions about basal cell carcinoma treatment
Who will treat my basal cell carcinoma?
Either Mr Ben Aldridge or Mr Kazem Nassar, depending on your preference and availability. Mr Aldridge is the UK’s only consultant dual-qualified in dermatology and plastic surgery, with a PhD in skin lesion diagnostics, co-author of national skin cancer guidelines, and chair of the South East Scotland Melanoma Multidisciplinary Team. Mr Nassar is a consultant plastic and reconstructive surgeon with over a decade of experience. Both perform BCC excision and reconstruction.
How quickly can I be seen?
Most patients are seen within 1 to 2 weeks of enquiry. Surgery is usually scheduled within two weeks of the first consultation. Histology is communicated within two weeks of surgery.
Will I need a biopsy before surgery?
Not always. For well-defined lesions where the clinical and dermoscopic appearance is consistent with BCC, excisional biopsy is usually the most efficient route — it removes the lesion and confirms the diagnosis at the same time. Where the diagnosis is less certain, a small diagnostic biopsy is taken first.
What anaesthetic is used?
Local anaesthetic for most cases. Sedation or general anaesthesia is offered for larger lesions, anxious patients, or more complex reconstructions.
What does the surgery involve?
The lesion is removed with a defined clear margin of healthy tissue. The wound is closed directly, with a local flap, or with a skin graft, depending on the site and size. Reconstruction is planned to place the scar in the most favourable position for the area.
What happens if the margins are not clear?
If histology shows tumour at the margin, a second procedure to clear the margin is recommended. Your consultant explains the histology report with you in person and books the further surgery if needed.
Do you offer Mohs micrographic surgery at Waterfront?
Mohs micrographic surgery is not performed at Waterfront. It is a specialist procedure most often used for BCCs in cosmetically or anatomically sensitive sites, particularly on the face. Where Mohs is the most appropriate treatment for your lesion, your consultant explains this at consultation and arranges referral to a Mohs centre via the NHS pathway.
What is the South East Scotland Skin Cancer MDT?
The Multidisciplinary Team brings together dermatologists, plastic surgeons, oncologists, radiologists and pathologists to plan treatment for complex skin cancers. Larger, recurrent, or anatomically challenging BCCs are discussed at this meeting where appropriate. Both Mr Aldridge and Mr Nassar sit on this MDT.
What is the recurrence risk?
Local recurrence after a fully excised low-risk BCC is uncommon. The risk is higher for larger lesions, lesions in high-risk facial sites, recurrent disease, and certain pathological subtypes such as infiltrative or morphoeic BCC. Your consultant reviews your specific risk profile after histology.
How often will I be followed up?
Follow-up is tailored to the features of your lesion. A single low-risk BCC fully excised may not require long-term follow-up beyond skin self-examination advice. Higher-risk lesions and patients with multiple BCCs are seen more often.
I’ve had several skin cancers — does that change my care?
Yes. Patients with multiple lesions, field change, or long-term sun damage benefit from a structured surveillance plan. Your consultant tailors this with you, and arranges any onward NHS pathway for genetic referral or systemic treatment where indicated.
How is treatment paid for?
Waterfront Private Hospital is self-pay. The guide price covers consultation, surgery, histopathology, and routine follow-up. Final pricing is confirmed in writing after clinical assessment.
Page author
Mr Kazem Nassar, MBChB, FRCS (Plast), GMC 7131999, is a Plastic and Reconstructive Surgeon Consultant with over 10 years of experience. He practices at St John’s Hospital and the Western General Hospital in Edinburgh, specialising in melanoma, skin cancer treatments, breast surgery, and post-cancer reconstructive surgery.
