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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 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:
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Surgical
removal of a thin layer of skin containing the
tumor.
-
Examination by
the Mohs Surgeon of each section under the
microscope.
-
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.
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.
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