In the last 10 years, incidents of skin cancer have gone up by more than 50 percent nationwide – which means Dr. James Kelly is a pretty busy physician.
Kelly is a plastic and reconstructive surgeon who deals with the ravages of skin cancer.
The job can be challenging for Kelly, one of the partners of the Center for Dermatology and Plastic Surgery – which has grown to nine clinics across the Valley, including Scottsdale, since he joined the practice in 2015.
“I do a lot of skin cancer reconstruction on the head and neck, nose, eyelids, ears,” he said, recalling how one of his more challenging surgeries involved the reconstruction of an ear.
“It basically was the entire ear,” he said. ‘All the earlobe was completely gone…I had to replace the cartilage in the ear and then also the skin on the front and back of the ear. So that required about three different surgeries to reconstruct the ear, rebuild it and put new cartilage in the ear to help support the ear.”
He sees a lot of the damage that unprotected skin can suffer from exposure to the sun. And the age range of patients is virtually limitless.
The sun generally inflicts most of its damage on people before they turn 30, but skin cancer can take decades to develop. Moreover, when older patients were that young, sunscreen products were not nearly as effective as they are today.
Consequently, “We definitely have a lot of patients 60, 70, 80,” Kelly said.
“But being in Arizona, we see a fair amount of younger people in their 30s and 40s with some pretty significant skin cancers,” he added. “I see a lot of pediatric patients that pediatricians and dermatologists send me.”
Of the 19 different medical providers at the Center for Dermatology and Plastic Surgery, Kelly is one of three types of physicians.
Besides dermatologists, the center also has Mohs micrographic surgeons.
Named after Dr. Frederick Mohs, the founder of micrographic surgery, they remove cancerous tissue while removing as little of the healthy tissue as possible.
They usually are the physicians whom patients see before they see Kelly – who has two Mohs surgeons on his team – in the hope that radical reconstructive surgery might be averted.
“Most patients will come in and they have a spot that’s not healing,” Kelly explained. “So we’ll biopsy it and once we determine it actually is skin cancer, then I would normally work with a Mohs surgeon.”
“They’ll look at the skin underneath the microscope immediately and make sure all the skin cancer is completely gone.”
But what happens if the Mohs surgeon removes enough tissue to create disfigurement is why Kelly and the Mohs surgeons coordinate their schedules with patients.
“I work hand in hand with them,” he said, explaining, “Nobody wants to have a half their ear missing and wait a week or so to see another doctor. So, when that patient is done with having a skin cancer removed, I can do reconstructive surgery if needed.”
“It’s in my same office. I meet patients, evaluate them, talk about what we need to do, how we need to fix this, and then we try to do that the same day. That way it’s just easier for the patient.
“That makes a big difference and that’s one of the things that attracted me to this practice.”
A Utah native, Kelly did his post-graduate medical training in North Carolina and Kentucky.
He recalled how in North Carolina, “most patients have to wait one to two weeks to get in to see a plastic surgeon, so they have a bandage on their nose or the ear for a week or so. It’s just not the best way to handle things.
“It increases the risk of infection, doesn’t have as good of an outcome. So, the way it is here, it’s nicer for the patient. We can evaluate immediately.”
Kelly, whose brother is an oral surgeon and a longtime Gilbert resident, had a lifelong ambition to become a doctor – partly because his father is a pediatrician.
“Ever since I was a kid, I wanted to be a surgeon, but I didn’t know what kind of surgeon,” he recalled.
But then he had the chance to go to Africa and Guatemala, where he helped doctors treat children and adults with significant burn injuries and birth deformities.
And those transformations he helped work on led him to plastic and reconstructive surgery.
“I liked the concept of plastic surgery that we operate on the entire body,” he said. “We can operate on adults, children. We kind of run the gamut.
“When I was a medical student and resident, I just loved the skin cancer aspect of it – taking care of patients with large skin cancers on their face and helping them. There’s an immediate sense of satisfaction in reconstructing the nose or the ear or the eyelid or whatever.
“So that’s what attracted me, the variety. Every day is something different….If the patient has a skin cancer on the nose, I don’t know if it’s going to be a small skin cancer or if it’s their entire nose that I have to reconstruct. So, it’s challenge. You have to use your creative skills trying to figure out how to reconstruct and how to solve their problem.”
And the potential for challenges is always there, especially since post-cancer reconstructive surgery accounts for 60 percent of reconstructive and plastic surgery that the Center for Dermatology and Plastic Surgery handles.
The rest is cosmetic, such as face and neck lifts, eyelid and breast enhancements and what Kelly called “kind of mommy makeovers.”
Kelly – who with his wife of 18 years, Ashley, has four children ranging in age between 3 and 12 – doesn’t let the skin cancer part of his work dissuade him from hiking and running.
“That’s one of my favorite things about living here is being able to be outside most of the year,” he said.
But Kelly takes no chances and thinks everyone should follow suit – meaning a nearly slavish attention to wearing protective clothing and good sunscreen at virtually any time under the sun and getting a skin cancer checkup every year.
The Center for Dermatology and Plastic Surgery is at 14275 N 87th St., Scottsdale. Information: 480-905-8485 or azcdps.com.