MOHs Surgery in Annapolis, MD
“Let us be your go-to place for skin cancers on the face and body. If you have been diagnosed with skin cancer come in for a consult. We can manage your treatment from start to finish and coordinate with a Mohs dermatologist if they are needed. You can expect the best possible repair by trusting us for your care.” – Dr. Henry D Sandel IV, MD FACS
Many patients who are diagnosed with a skin cancer on the face, nose, eyelids, lips, or ears are referred (by their primary care physician) to local Annapolis dermatologists who perform Mohs surgery. Mohs surgery is a technique that allows skin cancers to be removed in micro-stages. A very small rim of tissue is removed and immediately looked at under the microscope. If cancer is shown to be present in that specimen then a little more tissue is removed. Thus, giving the smallest possible area that completely removes the cancer.
If the cancer defect is in a difficult place to close or if patients are concerned about the scarring, then those patients are referred to facial plastic surgeons for repair. That is where we come in. The Sandel Duggal Center is proud to be a referral center for either simple or complex skin cancer reconstructions. We work with local dermatologists to help you achieve the most optimal outcome, both from the cancer resection to the reconstruction.
If you have been diagnosed with a skin cancer and are concerned about having it removed, contact our office. We will be happy to discuss your options for treatment, and coordinate with a Mohs surgeon if needed.
What is MOHs Surgery?
Mohs surgery is a way of removing skin cancer by serial excisions. The smallest area of visible cancer is taken first. The skin margins are then tested while you wait. If an area is still positive for cancer, then a little more skin is removed. This process is repeated until all of the cancer is gone, leaving as much normal skin surrounding the cancer intact.
This is important because only the cancer is removed, leaving normal skin behind. No longer do we have to make large incisions and wait a week for testing to make sure the cancer is gone.
How is MOHs Surgery Performed?
Mohs surgery is performed by specialized dermatologist, who are also trained in pathology. They have a lab set up in their office to process the specimens on site.
Dr. Sandel or Dr. Duggal may coordinate your cancer treatment with a Mohs dermatologist. They typically do the excision of the cancer, and you come back to our office the same day to have the wound repaired.
It is beneficial for us to see patients first, before the cancer is removed. This allows us to review the repair options once the cancer is removed. We can anticipate what defect may be present after Mohs surgery and plan accordingly. This results is the best possible outcomes with minimal scars.
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What Does Skin Cancer Look Like?
It is not easy to diagnose skin cancer. This usually requires a trained specialist to examine the area and perform a biopsy. Skin cancer can take on many forms and appearances. Some of the most common types are:
Melanoma is one of the most aggressive skin cancers. It is also one which can be more easily identified. Melanoma is commonly pigmented and irregular. These areas change in size rapidly and may become ulcerated. They may also occur from pigmented moles that you may have had for a long time. You should watch these moles carefully for any changes that may occur. If you notice the change in color, size, border irregularity or ulcerations let your physician know right away. Melanoma can be completely cured if caught early. However, it does have a high rate of metastatic spread.
Basal cell carcinoma is one of the most common skin cancers diagnosed on the face and neck. These cancers are usually colorless and appear as an area of irritation. Most patients state that they have this spot that just is not healing. As the cancer progresses, the area may become nodular, ulcerated, and bleed. These are the most concerning signs of skin cancer.
Squamous cell carcinoma is a common skin cancer that may present and spread more rapidly. Usually these cancers appear ulcerated and bleeding from the start. They progress rapidly therefor need quick diagnosis and treatment.
Types of Skin Biopsies
Shave Biopsies utilize a flat edge to remove a small section of the top layers of skin. Raised, nodular or flaking lesions are amenable to a shave biopsy. Because there is no incision, there is almost no noticeable scar using this technique. Most commonly shave biopsies are sufficient.
A Punch Biopsy requires a small instrument to remove a core sample of the area in question. This is a very reliable choice for certain lesions because the entire thickness of the skin can be examined by a pathologist. Because punch biopsies are so small, they only require one or two small sutures to close. The scar is small and mostly imperceptible.
Excisional biopsies are simply the removal of the entire lesion in question. This is performed in cases where closure is easily achieved and the patient wants the lesion removed anyway, whether cancer is diagnosed or not.
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The Sandel Duggal Center for Plastic Surgery is one of the top plastic surgery practices in Maryland and Dr. Claire Duggal has extensive experience in breast and body enhancement procedures. Schedule a consultation to learn whether breast augmentation is right for you, and to find out why Dr. Duggal’s patients rate her so highly. Contact us online or call 410-266-7120.