Mohs reconstruction with Dr. Henry Sandel
Mohs Surgery & Reconstruction
We are proud to be a referral center for either simple or complex skin cancer reconstruction, working with local dermatologists so you get the most optimal outcome — from the cancer resection through the repair.
Diagnosed with a skin cancer? Come to us first. We guide your care from there, coordinate with the Mohs dermatologist who removes the cancer, and repair the defect here the same day.
At a glance
Surgeon
Dr. Henry Sandel
Role
Reconstruction after excision
Referred by
Local dermatologists
Insurance
Often covered as medically necessary
What Mohs surgery is
Mohs surgery removes skin cancer by serial excisions. The smallest area of visible cancer is taken first, and the skin margins are tested while you wait. If an area is still positive for cancer, a little more skin is removed. This process repeats until all the cancer is gone, leaving as much normal skin surrounding it intact.
That matters because only the cancer is removed. No longer do we have to make large incisions and wait a week for testing to confirm the cancer is gone.
How the two halves fit together
Mohs surgery is performed by specialized dermatologists who are also trained in pathology, with a lab set up in their office to process specimens on site. Many patients diagnosed with skin cancer on the face, nose, eyelids, lips, or ears are referred to those dermatologists by their primary care physician.
If the cancer defect is in a difficult place to close, or if you are concerned about scarring, that is where we come in. Dr. Sandel or Dr. Duggal may coordinate your treatment with a Mohs dermatologist, who performs the excision, and you come back to our office the same day to have the wound repaired.
Why we ask to see you first
Seeing you before the excision is what lets the two halves work as one. We review your repair options, anticipate the defect the excision will leave, and agree the plan with your Mohs dermatologist in advance.
The reconstruction is then planned around the defect rather than improvised after it, and your repair is scheduled here for the same day, so the wound is closed without delay. That is what produces the best outcome with minimal scarring.
Mohs reconstruction before and after — an actual patient.
Cheek reconstruction following Mohs excision — the defect at presentation, and the healed repair.
Dr. Sandel’s approach
“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.”
Common types of skin cancer
Melanoma
Basal cell carcinoma
Squamous cell carcinoma
Skin cancer is not easy to diagnose. It usually requires a trained specialist to examine the area and perform a biopsy.
Related procedures
Types of skin biopsies
Three ways a lesion is sampled.
Shave biopsy
Uses 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. Most commonly, shave biopsies are sufficient.
Punch biopsy
A small instrument removes 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. Punch biopsies are so small they only require one or two sutures, leaving a small and mostly imperceptible scar.
Excisional biopsy
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.
Insurance
Medically necessary care is often covered.
Reconstruction after Mohs excision of a skin cancer is medically necessary care, not elective surgery, and insurance typically covers it.
Dr. Sandel is an out-of-network provider. If your insurance company offers you out-of-network benefits, you could be reimbursed for the medically necessary portion of your care. We will give you the medical notes, procedure codes, and diagnostic codes to help with this process.
Diagnosed with skin cancer?
Contact our office and we will discuss your options for treatment, and coordinate with a Mohs surgeon if needed.