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Surgical Dermatology

As dermatologic surgeons, we are highly experienced in skin cancer surgery and in the removal of benign growths and moles. We use the most advanced surgical techniques to achieve optimal medical and cosmetic results for each patient. We specialize in cutting-edge surgical dermatology procedures including Mohs skin cancer surgery.

Skin Cancer Surgery

There are several skin cancer surgery techniques used at Island Dermatology. The type that is used in a particular case will depend on the stage of cancer development. Pre-cancerous lesions can be treated with non-surgical methods including liquid nitrogen therapy  (burning / freezing) or medium depth chemical peels. A simple surgical excision of cancerous cells is performed when skin cancer is in an early stage. However, when the skin cancer has progressed or has developed in a cosmetically sensitive area, a more aggressive technique, such as Mohs Micrographic Surgery, may be necessary.

Mohs Surgery

Mohs Micrographic Surgery is state-of-the-art treatment in which the physician serves as dermatologist, pathologist and reconstructive surgeon. The procedure is performed with microscopic examination of the removed cancerous tissue. The surgery is extremely precise so that the greatest amount of healthy tissue is spared. Mohs surgery is often used to treat cancerous lesions on highly visible areas of the body, such as the face, where tissue preservation is desirable for cosmetic and functional reasons. A dermatologist trained in Mohs Surgery is able to precisely identify and remove the entire 

skin cancer leaving healthy tissue unharmed. Mohs surgery is most often used in treating two of the most common forms of skin cancer: basal cell carcinoma and squamous cell carcinoma.

The cure rate for Mohs Micrographic Surgery is the highest of all treatments for skin cancer. This procedure, the most exact and precise method of tumor removal, minimizes the chance of regrowth and lessens the potential for scarring and disfigurement.

Procedure
Mohs Surgery is a complex procedure combining surgical excision with immediate microscopic examination of the entire tissue specimen margin by frozen tissue processing techniques right in the office. During Mohs surgery at Island Dermatology, cancerous tissue is removed layer by layer and examined under a microscope. Layers are removed until all cancerous tissue has been eliminated.

It consists of the following steps:

  1. Surgical removal of a thin layer of skin containing the tumor.

  2. Examination by the Mohs Surgeon of each section under the microscope.

  3. If the tumor is removed completely, the skin defect is repaired. If the specimen shows tumor remaining, the above steps are repeated until skin is free of cancer.

 

The Mohs Surgery technique allows us to examine 100% of the surgical margin and, if tumor is still present, pinpoint the precise location of the leftover cancer. This allows us to selectively remove another layer of skin from the area where the cancer remains. This minimizes the amount of normal skin that is removed. Since some skin cancers removed with Mohs Surgery are complicated, multiple stages may be necessary. If multiple stages are taken, the Mohs procedure can take up a good part of the day, so you must reserve the entire day for surgery.

Reconstruction
When the final defect is known, management is individualized to achieve the best results and to preserve functional capabilities and maximize aesthetics. The Mohs surgeon is trained in reconstructive procedures and will perform the reconstructive procedure necessary to repair the wound. A small wound may be allowed to heal on its own or may be closed with stitches, a skin graft or a flap. If a tumor is larger than initially anticipated a plastic surgeon may be needed to complete the reconstruction.

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Patient Education - Mohs Surgery ACMS 
Growth and Mole Removal

In addition to the removal of skin cancer, our dermatologists are experienced at removing benign moles and skin growths for cosmetic reasons. Moles and benign tumors can mar the appearance of otherwise attractive skin and can be a nuisance when they rub on clothing or impede shaving. For these reasons, mole removal can be a great solution.