Plastic Surgeon or Dermatologist?

It's one of the most common questions after a skin cancer diagnosis — and the honest answer is that it's usually not either/or. The two specialties do different jobs, often on the same patient. Here is who does what.

The short answer

Two specialties, one pathway

Dermatologists are the experts in diagnosing skin cancer and in several ways of treating it — including topical therapies, curettage, standard excision of suitable lesions, and Mohs micrographic surgery, which offers the highest cure rate for many facial skin cancers. Plastic and reconstructive surgeons are the experts in surgical removal in demanding locations and in reconstruction — repairing the defect so the nose still looks like a nose, the eyelid still closes and the lip still seals.

Many patients see both: a dermatologist who finds and clears the cancer, and a plastic surgeon who repairs the result. The pathway is collaborative, not competitive — skills genuinely overlap in the middle.

See a dermatologist

When the dermatologist leads

A spot needs diagnosis — dermoscopy, biopsy, surveillance of many lesions
Field damage or superficial cancers suit non-surgical treatment
A facial BCC or SCC is high-risk or recurrent and Mohs surgery is recommended
You need ongoing skin-check surveillance after treatment

See a plastic surgeon

When the plastic surgeon leads

The cancer sits in a difficult location — nose, eyelid, lip, ear, scalp — where repair quality determines how you look and function
The defect after excision or Mohs needs a flap or graft rather than simple closure
Excision and reconstruction are best done in one operation under one anaesthetic
Appearance matters to you and the repair deserves a reconstructive standard

How it works in practice

A typical journey

Your GP or skin-check clinic finds a suspicious spot → a dermatologist confirms the diagnosis → depending on the lesion, either the dermatologist treats it, or you're referred for surgical excision and reconstruction, or Mohs surgery clears it and a plastic surgeon repairs the defect — often the same day. Dr Kim has worked inside this pathway for years: he has taught dermatology registrars for the Australasian College of Dermatologists for nine years and reconstructs for many of Sydney's Mohs surgery specialists.

Common questions

Questions patients ask

Can a plastic surgeon remove the skin cancer as well as repair it?

Yes. Dr Kim performs both excision and reconstruction, often in a single operation, with pathology confirming clear margins. For high-risk facial lesions where Mohs is recommended, he reconstructs after the Mohs surgery specialist has cleared the cancer.

Do I need to choose between them?

No — the referral pathway usually decides it for you, and the two specialties coordinate directly. If you're unsure where to start, your GP or a dermatologist skin check is the right first step for diagnosis.

Who should repair a defect on the nose, eyelid or lip?

These are the least forgiving sites on the face — repairs there are the core of reconstructive plastic surgery, and it's where specialist reconstruction earns its keep.

Does seeing both specialists cost more?

Each specialist consultation attracts its own Medicare rebate with a valid referral. Skin cancer treatment is medically indicated, so item numbers generally apply throughout the pathway.

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Enquiries & referrals

Consultations in Sydney CBD and North Sydney. Referrals from GPs, dermatologists and Mohs surgery specialists welcome. Email surgery@drleokim.com.au.

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