“Skin cancer – usually basal cell carcinoma or squamous cell carcinoma – typically develops after years of sun exposure, often in visible areas such as the face or neck”, explains Valérie D’Hondt. “That kind of change to your face has a major impact. It can take up to a year for the skin to fully heal.” During her clinical rotations, she noticed that patients frequently became self-conscious about their appearance after skin cancer surgery. “They didn’t receive much information about how long it takes for a scar to settle.” To better understand this process, she had 217 patients fill in an existing questionnaire at three, six and twelve months post-surgery. “A lot changes during that first year. We asked people questions like whether they felt stared at, or hid their face.”
Wound closure techniques
“The way a wound is closed also affects how patients feel”, she says. “With secondary healing, the wound is left open to heal on its own, which takes time and requires daily care. It’s constantly on your mind.” A skin graft uses skin from another part of the patient’s body, like the neck. “A straightforward procedure, but it often results in a colour mismatch.” Local flap reconstruction, where immediately adjacent skin is used to close the wound, usually provides a better cosmetic end result, but initially causes more swelling and scarring.
A year
It proved difficult to follow all 217 patients for a full year. “But that alone revealed something: the less stress a patient feels, the less the scar occupies their mind.” It was only after a year that patients began to feel noticeably better about their appearance. “This shows that there’s a clear need for better information. Patients need to know what to expect.”
Plastic surgery
D’Hondt now works as a junior doctor in plastic surgery in the Eindhoven region. It’s a broad field, she explains, covering everything from hand surgery and reconstructive procedures (after skin cancer or mastectomy, for instance) to cosmetic procedures such as eyelid lifts. “I’m especially drawn to reconstructive surgery – it allows for creative problem-solving. I enjoy working with my hands, and I love operating.” Her dream is to train as a plastic surgeon. As for the prize money: “I’ve got an active holiday in the Dolomites coming up.”