Mohs Reconstruction and Skin Cancer Surgery

Everyone who spends time outside without sun protection is at risk for developing skin cancer—the most common form of cancer in the nation—and even brief periods spent outdoors can expose individuals to the harmful ultraviolet rays (UV) of the sun. In addition to increasing the risk for skin cancer, the sun also is primarily responsible for approximately 90 percent of common signs of aging. Fortunately, there are numerous procedures now available to treat this damaging condition. In fact, skin cancer treatments have become one of the most commonly performed reconstructive plastic surgery procedures. At our practice, extensively trained plastic surgeon Neal Goldberg, MD offers some of the most advanced skin cancer treatments available.

The most common form of skin cancer is basal cell carcinoma (BCC), with over 2.8 million instances of this condition diagnosed in the U.S. every year. Though rarely dangerous, BCCs potentially can be disfiguring if left untreated. The carcinoma begins in the basal cells of the lower epidermis (upper layer of skin), typically developing quite slowly. These growths rarely metastasize or become fatal; however, they may cause substantial visible damage to the skin if neglected.

After BCCs, the next most common form of skin cancer is called squamous cell carcinoma, or SCC. This type of cancer also develops slowly; however, there is an increased chance of metastasizing and becoming a serious health risk. SCCs begin in the squamous cells of the upper epidermis layers, higher up than with the BCCs. Every year, this variety of skin cancer is responsible for about 2,500 deaths in the U.S.

The third category of skin cancer is called melanoma. Although this type is the rarest, melanoma is also the most deadly. Melanoma begins in the basal layer of the epidermis, the deepest of the five layers. This carcinoma often be recognized as an unusual looking mole, typically appearing uneven in shape or color, larger than the head of a pencil eraser, or exhibiting changes in shape or color over time. The mark may appear as a brand new mole or develop within an existing one. There can be a strong genetic component associated with melanoma, as well as a high recurrence rate. It is important to diagnose and treat melanoma quickly, as this condition is responsible for approximately 9,710 deaths annually.

For more information about skin cancer treatments, or if you wish to schedule a consultation with Dr. Goldberg, please contact us today.

Candidates For Skin Cancer Surgery

Patients who have been diagnosed with BCC in the past are at a greater risk for eventually developing SCC. Additional influences that could increase an individual’s skin cancer risk include genetic predisposition, exposure to carcinogenic chemicals, a suppressed immune system, and contributing infections.

Overview Of Skin Cancer Surgery

There are several surgical options for treating skin cancer, such as excision, curettage (a method of scooping or scraping out tissue), Mohs micrographic surgery, cryotherapy (an approach utilizing liquid nitrogen), and radiation therapy. Typically producing a 98 percent success rate or higher, Mohs micrographic surgery has the most significant results of any treatment when it comes to treating BCC and SCC.

The tissue-sparing approach used in Mohs micrographic surgery is one of the primary benefits of this procedure. Dr. Goldberg will excise each individual layer of tissue and microscopically examine the skin for signs of cancer cells. If found, he will continue with another layer, again analyzing the tissue for cancer, until there are no more to be found. Typically, more healthy tissue can be spared with Mohs micrographic surgery than with other common cancer treatments.

The other surgical options employ a variety of methods to remove the cancerous tissue. Curettage requires a specialty instrument, called a curette, to scrape away the infected tissue. To address any remaining cancer cells, an electrocautery needle delivers electricity to the affected area. Liquid nitrogen is utilized during cryotherapy to freeze the cancer cells, ultimately destroying them. If surgery is no longer an option due to the cancer spreading to other areas of the body or tumors that are developing, radiation therapy is the most commonly performed approach. Once radiation has been applied, it may be possible to remove the tumors surgically, and then analyze the region microscopically to ensure the diseased cells have been eliminated.

Post-Operative Treatment For Skin Cancer

Most individuals report that Mohs micrographic surgery causes only mild discomfort, swelling, and bruising. Dr. Goldberg will discuss all aspects of the procedure with you during your initial consultation and give you an idea of what to expect during recovery.

If you would like to speak to Dr. Goldberg about Mohs micrographic surgery or other skin cancer treatments, or if you have additional questions about these procedures, please contact us today.

“I was sent to Dr. Neal Goldberg with an open surgical wound on my head. A circular-sized Basal Cell Carcinoma was removed from the front portion of my scalp and a portion of my hair had to be shaved for it’s removal. Dr. Goldberg’s office staff was welcoming and kind. I arrived at what would normally be a lunch hour and was made to feel comfortable and was treated with care. Dr. Goldberg settled my fears immediately. He closed the wound on my scalp with precision and compassion and answered all of my questions. I felt that I was truly blessed that Dr. Goldberg made time in his schedule that day to perform the plastic surgery to close my scalp. His skillful hands have made me whole – my wound has healed and my hair growth has rejuvinated. Thank you Dr. Goldberg!”
- Jo-Anne G