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Mohs Micrographic Surgery

About Dr. Hootan Zandifar

Dr. Hootan Zandifar is board-certified in Otolaryngology and fellowship-trained in Facial Plastics and Reconstructive Surgery. Dr. Zandifar is the director of the Skin Center at the Osborne Head and Neck Institute based at Cedars-Sinai Medical Towers.

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Is Mohs surgery right for my skin cancer?

Question: I was recently diagnosed with a skin cancer lesion on my cheek. After biopsy I was told that my lesion was a basal cell carcinoma that was most likely caused by years of unprotected sun exposure. My doctors have advised me to have the lesion removed to avoid any complications. I have heard that the best procedure for skin cancer removal is Mohs surgery. Is Mohs appropriate for my lesion?

Discussion:

Mohs micrographic surgery is a highly effective procedure most commonly used for the removal of basal cell and squamous cell carcinomas of the skin.  These tumors have been routinely treated in the past with traditional surgical excision techniques that typically required large margins of tissue to ensure removal of any microscopic traces of malignancy. The goal of these traditional techniques was to decrease the likelihood of tumor recurrence. Mohs surgery is able to accomplish these goals with a higher level of efficacy and with smaller tissue margins.

Figure 1: High-risk skin cancer lesion on the bridge of the nose exhibiting poorly defined borders. This lesion would typically be a good candidate for Mohs surgery.
Figure 1: High-risk skin cancer lesion on the bridge of the nose exhibiting poorly defined borders. This lesion would typically be a good candidate for Mohs surgery.

Mohs surgeons typically begin by removing concentric areas of tissue around the visible tumor that are simultaneously examined under a microscope for evidence of cancer cells. This process is repeated during the surgical procedure until there is no longer any apparent evidence of cancer in the surrounding tissue.

In all cases of suspected skin cancer, comprehensive evaluation by a skin specialist is highly advised. A skin specialist can suggest a treatment plan that is best suited to your specific cancer type and lesion characteristics. These physicians are specially trained in preserving the functional and aesthetic properties of your skin while treating your cancer.

Dr. Hootan Zandifar, director of the Skin Center at the Osborne Head and Neck Institute is board certified in plastic surgery and reconstructive surgery as well as otolaryngology. This unique combination of specialties allows Dr. Zandifar to treat effectively treat skin cancers while preserving the delicate facial architecture of the patient. Dr. Zandifar takes into account the complex functional processes of the skin and its related structures while treating his patients. Furthermore, Dr. Zandifar is widely acclaimed for his superior results and high rate of patient satisfaction.

Key Facts:

  • While highly effective for the excision of certain skin malignancies, Mohs micrographic surgery may not be the ideal procedure for every skin cancer patient.
  • Mohs surgery is a labor intensive, time consuming, and expensive procedure that can only be performed by a limited number of specially trained Mohs surgeons.
  • Treatment with Mohs surgery is typically reserved for Squamous Cell Carcinoma and Basal Cell Carcinoma tumors that exhibit high-risk characteristics or are located in critical or functional areas.
  • Melanoma, the most aggressive form of skin cancer, is typically not treated with Mohs surgery because these types of cancer cells are not as effectively identified and removed as in traditional procedures.
  • In all cases of suspected skin cancer, comprehensive evaluation by a skin specialist is highly advisable.
  • Dr. Hootan Zandifar, director of the Skin Center at the Osborne Head and Neck Institute is board certified in plastic surgery and reconstructive surgery as well as otolaryngology. This unique combination of specialties allows Dr. Zandifar to treat effectively treat skin cancers while preserving the delicate facial architecture of the patient.

Please contact the Osborne Head and Neck Institute to learn more about skin cancer and Mohs Micrographic Surgery.

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