There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma. One in five adults will be diagnosed with one of these forms of skin cancer by the age of seventy, rendering this malignancy the most common in the United States. Unfortunately, these cancers tend to occur in highly visible areas of the body such as the face, neck, chest, upper back, arms and legs. Definitively curing your skin cancer is always the primary objective; however, given the conspicuous location of these tumors, the resultant aesthetic appearance and functionality of the treated site must also be considered.
Mohs micrographic surgery is a highly specialized skin cancer surgery that effectively removes the tumor with minimal damage to the surrounding healthy skin. The wound left by your skin cancer surgery is then repaired in a manner that optimizes your aesthetic and functional outcomes, a process that requires the expertise of a skilled reconstructive surgeon.
Dr. Hooman Khorasani is a fellowship-trained Mohs micrographic surgeon with additional board certification in dermatology, cosmetic surgery, and facial cosmetic surgery. As such, he is one of the few Mohs micrographic surgeons capable of both removing your cancer and expertly repairing the treated area. This unique competency in both Mohs micrographic surgery and reconstruction has earned Dr. Khorasani an international reputation of excellence and multiple peer-reviewed research publications. More importantly, patients undergoing skin cancer surgery with Dr. Khorasani can rest assured that they are receiving comprehensive care that maximizes both their medical and cosmetic results.
To find out how Mohs micrographic surgery and reconstruction with Dr. Khorasani can specifically treat your cancer while optimizing your aesthetic outcome, visit us at our New York City practice. To request a consultation, message us securely, or contact Dr. Khorasani’s Manhattan office by phone at 347-574-8500.
WARNING: GRAPHIC PHOTOS BELOW
Your skin is composed of millions of cells. Sun exposure, age, genetics, stress and other factors can cause some of these cells to mutate and behave abnormally. These mutated cells multiply rapidly and form cancerous tumors in the skin. The specific type of cell involved in this abnormal growth pattern determines if the cancer is a basal cell carcinoma, squamous cell carcinoma, or melanoma. Basal cell carcinomas typically appear as pearly flesh-colored moles or pimples that do not resolve with time. Squamous cell carcinomas are similarly persistent, but are often rough, scaly patches that are red or brown in color. Finally, melanomas often result from previously existing moles that have undergone a change in shape, color, size, or texture. It is important to note that not all basal cell carcinomas, squamous cell carcinomas, or melanomas will necessarily have these features. As such, it is critical to have any suspicious skin blemishes evaluated by a dermatologist as soon as possible.
Treatment of your skin cancer depends on its type, stage (as determined by your dermatologist and pathologist), location, and your overall health. It is very important to understand that your initial biopsy did not remove the skin cancer, even if you can no longer physically see the original blemish. The biopsy is often a sample of the “tip of the iceberg” as these tumors often have deeper roots which will require further treatment. All biopsies require immediate follow-up with your dermatologist to determine the best treatment for your particular skin cancer.
Patients with basal cell or squamous cell carcinomas confined to the skin’s surface, called the epidermis, may be candidates for treatment with our PreciseFX laser. This cutting-edge therapy capitalizes on Dr. Khorasani’s extensive skin cancer knowledge and technical mastery of laser energy to rapidly eradicate surface-level tumors with minimal scarring. Visit our Skin Cancer Laser Treatment page to see if PreciseFX laser may provide you with the best medical and cosmetic results for your superficial skin cancer.
Melanoma, the most dangerous of skin cancers, must be treated aggressively with surgery and occasionally with adjuvant chemotherapy, and/or radiation. Non-superficial basal cell carcinomas and squamous cell carcinomas also require surgical treatment, of which Mohs micrographic surgery is traditionally the gold standard.
Mohs micrographic surgery involves removing the visible skin cancer and a narrow margin of healthy skin for microscopic evaluation. Following a specialized preparation process, the bottom and all the edges of the specimen are carefully examined under a microscope to determine if there are additional skin cancer cells that were imperceptible to the human eye. If these invisible cancer cells exist, their position is carefully marked on a hand-drawn map of your tumor. The surgeon will then remove additional tissue in the precise location of these tumor cells, sparing the surrounding healthy skin. This process, called staging, is repeated until the bottom and all the peripheral edges of the specimen are cancer-free.
The benefits of Mohs micrographic surgery are numerous, as this specialized surgery provides patients with multiple medical, aesthetic, and financial advantages.
Mohs micrographic surgery is often the most cost-effective treatment, especially for those with busy professional and personal lives. The cancer is removed in an outpatient setting using local numbing injections, avoiding the tremendous costs and prolonged recovery of inpatient surgery with general anesthesia. Mohs micrographic surgeons are also pathologists, meaning that they both remove the cancer and evaluate the specimen under a microscope. This dual expertise eliminates the need to involve additional high-cost collaborators, the savings of which are passed down to the patient. Mohs micrographic surgery with Dr. Khorasani is particularly advantageous for patients, as the cancer removal and subsequent reconstruction of the wound are performed within a single office visit. This spares patients from wasting time visiting multiple doctors over a span of days and accruing unnecessary fees.
Medically, Mohs micrographic surgery allows for 100% of the tumor margins to be closely examined for the presence of cancer cells. This stands in stark contrast to traditional skin cancer surgery in which only 1% of the tumor margins are evaluated for malignancy. The comprehensive evaluation offered by Mohs micrographic surgery is responsible for its excellent cure rates, which range from 94% for cancer that recurred after previous treatment to 99% for new cancers. These impressive figures have led Mohs micrographic surgery to be considered the gold standard for the treatment of basal cell and squamous cell carcinomas.
The precision of Mohs micrographic surgery allows for the removal of the least amount of healthy skin, resulting in the smallest wound possible. Wound size is a critical determinant of the reconstructive process, and, in general, the aesthetic outcome is inversely related to the total area of the defect. Dr. Khorasani is acutely aware of this important correlation, since he serves as both a Mohs micrographic surgeon and a reconstructive surgeon. Consequently, he is meticulous in removing only what is absolutely necessary to ensure that the cancer has been completely eradicated. Utilizing his cosmetic surgery expertise, the resultant wound is reconstructed in a manner that maximizes your aesthetic and functional outcome. The result? Preservation of your natural appearance and skin that is 100% cancer-free.
Repairing a wound after Mohs micrographic surgery is called reconstruction, as this process aims to restore the original functionality and cosmesis of the treated area. Very small wounds may heal appropriately with minimal intervention; however, most defects will require some degree of surgical repair.
The size and location of the wound will determine the reconstructive method used. Capitalizing on his decade-long experience repairing over sixteen thousand Mohs micrographic surgery wounds, Dr. Khorasani will create a reconstructive surgical plan that is tailored to your specific medical and aesthetic needs. Small, simple wounds in relatively inconspicuous areas may be reconstructed to form a single straight scar in the treated area. Readily visible large or complex wounds require advanced reconstructive techniques to restore your natural appearance and function. These may include shifting nearby healthy skin to cover the wound (called a skin flap) or transplanting excess skin from another bodily area to the defect (called a skin graft). Although these procedures are more involved, Dr. Khorasani will carefully evaluate the natural contours of the treated area to create a personalized surgical plan that will result in the least obtrusive scarring and maximum functionality.
Please see our Before & After Gallery to view examples of Dr. Khorasani’s Mohs micrographic surgery wounds before-and-after reconstruction.
Dr. Khorasani and his highly-specialized team look forward to working with you to transform your medical or aesthetic goals into reality. To expedite a request for a consultation, message us securely, or contact Dr. Khorasani’s Manhattan office by phone at 347-574-8500. For more information about how to get in touch:CONTACT US