What are the types of skin cancer and why should a plastic surgeon treat them?

There are numerous types of skin cancer but the most common types include Basal Cell Cancer (usually a pearly bump on the skin with an associated blood vessel), Squamous Cell Cancer (usually has a flaky appearance), and Melanoma (usually a brown/black spot with irregular edges).  These definitions are general and not all encompassing. Most skin cancer is associated with excess sun exposure.

Skin cancer lesions can be identified based on the acronym ABCDE:


Border irregularity 

Color that is not uniform 

Diameter greater than 6 mm

 Evolving or changing  

Skin cancers are usually diagnosed by a primary care physician or dermatologist through a biopsy. In addition you should always do self-check and monitor any suspicious moles.

If your biopsy shows skin cancer, you will usually require excision of the lesion to ensure it has been adequately removed.  Sometimes, you may wish to have a plastic surgeon remove the skin cancer or perform the reconstruction after the cancer has been removed, especially if it is in a cosmetically sensitive location.  Plastic surgeons have training in advanced reconstructive techniques, including skin graft and flaps (or re-arrangement of your own tissues) and focus on suturing techniques that minimize scarring.

Having a cancerous lesion can be scary but the removal of one doesn’t have to be. Dr. Elswick performs skin cancer lesion removal at our office located in Troy, Michigan. She accepts most insurance companies.  Call today to set up your appointment 248-524-0620.  

Dr. Sarah Elswick

Plastic, Reconstructive and Aesthetic Surgery

How is fat grafting used in Breast Reconstruction Surgery? 


Fat grafting is a way to transfer fat cells from one part of the body to another part of the body, in this case to the breasts.  The fat is collected via liposuction, processed, and then injected into the desired location. The fat can be harvested from any area with excess or undesirable fat.  Typical locations include the abdomen, flanks or love handles, and inner thighs and knees.


The fat can be utilized in multiple different ways.  First and foremost it is used to smooth out any contour irregularities or asymmetries in the breasts.  Similarly, it can be used to camouflage the edges of the implant or improve the appearance of rippling from the implant.  Fat grafting can also be used to enhance the volume of the breast, either by itself or in combination with an implant. If a large volume of fat is required, multiple fat grafting surgeries may be required.  It is possible to create a breast entirely with fat grafting depending on the amount of fat you have available and the size of breast you desire. Fat grafting can also be utilized to improve contour irregularities associated with lumpectomies.


Fat grafting is done at second stage or revisional procedures, not at the time of mastectomy. Usually fat grafting is performed in conjunction with other procedures so the length of the procedure depends upon what other procedures are being done.  In general, fat grafting takes anywhere from 45 minutes to 1.5 hours.


Dr. Elswick performs fat grafting in breast reconstruction cases as well as cosmetic surgeries. It provides beautiful natural results and is appealing to the individual who wishes to use their own body tissues to rebuild and restore their body. Call today to schedule your consultation.  248-524-0620


Dr. Sarah Elswick

Plastic, Reconstruction and Aesthetic Surgery :


What is Goldilocks Breast Reconstruction?


Traditionally Goldilocks Breast Reconstruction was used to describe a type of breast reconstruction where the skin and fat left after a mastectomy was rearranged in such a way to create a breast.  The tissue from the lateral breast and chest wall can also be recruited to provide additional volume. This technique works well in women with large breasts who want smaller breasts postoperatively and fits the adage of “not too big, not too small, but just right” – Goldilocks and the Three Bears story.


There are multiple applications of Goldilocks Reconstruction:

  • The reconstruction can be performed in the traditional aspect, rearranging the patient’s own tissues to create a new, smaller breast.  If desired, the patient can undergo one or more episodes of fat grafting to enhance the size or shape of the breast.
  • The reconstruction can be performed in combination with a tissue expander and/or implant for women with large, droopy breasts desiring better breast shape with a more youthful and “perky” appearance.
  • The reconstruction can be performed in patients who do not want reconstruction but want to limit or prevent the concavity that can be caused by a mastectomy.


This surgery is done at the same time as the mastectomy.  The surgery usually takes 1.5-2 hours depending on whether you are having single or double mastectomies.  This is in addition to the time it takes to complete the mastectomy. Patients are usually hospitalized for one night after a mastectomy with Goldilocks Reconstruction.


During the consultation I will evaluate your specific case and present all the options that are available to you.  We are committed to helping you close the loop on breast cancer and have confidence to move forward. Call today to schedule your consultation. 248-524-0620.


Dr. Sarah Elswick, MD

Plastic, Reconstructive and Aesthetic Surgery 

Considering facial fillers? Don’t forget your Chin!






Kristen Lotz, PA-C

Aesthetic Injector

What is direct to implant breast reconstruction surgery?

Knowing your surgery options for breast reconstruction is critical for making the right decision.  This week I want to talk about direct to implant reconstruction. In direct to implant surgery the permanent implant is placed at the time of mastectomy, avoiding the need for a tissue expander.  This surgery is also referred to as “single stage” breast reconstruction. I prefer, however, not use this term due to the fact that many women still require a revisional surgery to optimize breast shape, scars, or symmetry.

Candidates for direct to implant reconstruction include women with small to moderate size breasts that want to have the same breast size or smaller breast size post-operatively.  Large implants can cause strain on the breast skin after the mastectomy which may lead to implant failure. As the reconstructive surgeon I would closely with your breast surgeon to ensure you receive the best treatment available.  The reconstructive

 surgery usually takes 1-1.5 hours depending on whether you are having single or double mastectomies.  




Dr. Sarah Elswick, MD

Plastic, Reconstructive and Aesthetic Surgery


What’s the new trend in Lip filler? 






Raquel Merlini

Registered Nurse and Aesthetician

What is a tissue expander?

Intro to series, Breast reconstruction surgery has several different approaches.  Due to this and the complexities of the surgery patients typically have lots of questions and may feel overwhelmed.  Dr. Elswick would like to offer a blog series on answering several of these questions to help patients increase their knowledge and make informed decisions.  She is passionate about breast reconstruction surgery and works one on one with her patients to ensure every question is thoroughly answered before moving forward.  


We have several questions already in mind to answer but welcome additional ones from you. Our first question is: 


What is a tissue expander?


A tissue expander is one of the more commonly used devices in breast reconstruction.  A tissue expander is a temporary “spacer”, similar to a balloon, which allows the plastic surgeon to preserve the volume and shape of the breast.  It is shaped like a breast and has a “tear drop” appearance when viewed from the side. The outer shell of the tissue expander is made of silicone.  


There are different sizes of tissue expanders, so it can be individualized to fit your body and reconstructive goals.  Unlike a breast implant, a tissue expander has a port that is connected to the inside cavity. The port is identified with a magnet and accessed through your skin so the expander can be filled post-operatively with either air or fluid.  A tissue expander is used as a temporary device to help create a nice pocket to hold the final implant while also expanding or stretching the breast skin to create the desired post-operative size and shape. When the tissue expander fills are complete and the skin and incisions have healed, the tissue expander is removed and replaced with a permanent implant (three to six months after your expander surgery or radiation).


Attached is a photo of a tissue expander. During your consultation, I will have one available for you to physically see and touch to help you better understand the device.  Please call my office located in Troy, Michigan to set up your consultation. 248-524-0620. Together we can restore your body and confidence. 


Sarah M. Elswick, MD 

Reconstructive, Plastic and Aesthetic Surgery 

Jeuveau™ is here!

A new aesthetic treatment to treat aging skin. 





Raquel Merlini, RN


Filling the Temples

Adding Volume to the Temple area can add youth~ 










Kristen Lotz, PA-C

Michael J. Schenden, MD PC 

Lunchtime procedures due have some restrictions 




Things to avoid after Wrinkle Relaxing Injections


  • Avoid lying down for 4 hours after injection.
  • Avoid excessive amounts of alcohol for one day after injections. 


Things to avoid after Dermal Filler Injections






Kristen Lotz, PA-C