Dermatologic
Surgery

Mohs Micrographic Surgery (MMS) is a specialized surgical technique used to treat skin cancer, especially basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). It is a precise and effective method for removing skin cancer while minimizing the removal of normal, healthy tissue. Mohs surgery is named after its developer, Dr. Frederic Mohs, who first described the technique in the 1930s.

The Procedure


Mohs surgery is performed in stages, with each stage involving the removal of a thin layer of tissue from the affected area. The tissue is immediately examined under a microscope to determine if any cancer cells remain. If cancer cells are still present, the process is repeated until all of the cancer cells have been removed. This ensures that the maximum amount of normal tissue is preserved, while the cancer is completely removed.

Advantages


Mohs surgery offers several advantages over traditional skin cancer treatments. One of the main benefits is its high success rate in treating skin cancer, especially BCC and SCC. According to the American College of Mohs Surgery, the cure rate for BCC and SCC can be up to 99% with Mohs surgery. Additionally, because the tissue is examined during each stage of the procedure, the surgeon can see the extent of the cancer and ensure that it is completely removed.

Another advantage of Mohs surgery is its ability to minimize scarring. Because only the minimum amount of tissue necessary is removed, the size of the surgical wound is minimized. This results in a smaller scar and a quicker recovery. Furthermore, because Mohs surgery is often performed on cosmetically sensitive areas, such as the face, reduced scarring is especially important.

The high success rate and the ability to minimize scarring makes Mohs surgery an important option for individuals with skin cancer. It is important to discuss the potential risks and benefits of Mohs surgery with your healthcare provider before starting treatment.

Mohs surgical reconstruction refers to the process of repairing and restoring the skin and underlying tissue after Mohs micrographic surgery, a type of skin cancer removal procedure. The goal of Mohs surgery reconstruction is to achieve a functional and aesthetically pleasing outcome, while minimizing the risk of recurrence and optimizing healing.

During Mohs surgery, a thin layer of cancer-containing skin is removed and examined under a microscope to determine if all of the cancerous cells have been removed. This process is repeated until the entire cancerous area has been excised. The removal of large or complex cancerous areas can result in significant tissue loss, requiring reconstruction to restore the function and appearance of the affected area.

The choice of reconstruction method depends on the size and location of the defect, as well as the patient’s individual anatomy, medical history, and goals. Common techniques used in Mohs surgery reconstruction include local flaps, regional flaps, skin grafts, and tissue expansion. Local flaps involve moving nearby skin to cover the defect, while regional flaps involve the transfer of skin and underlying tissue from a more distant location. Skin grafts involve the transfer of healthy skin from a donor site to the area of tissue loss, while tissue expansion involves the gradual stretching of skin over a period of time to create more skin to cover the defect.

After reconstruction, the patient will typically need to follow a period of postoperative care, which may include wound care, bandage changes, and follow-up appointments with the reconstructive surgeon. The reconstructed area may take several months to fully heal, during which time it is important to protect it from sun exposure, avoid activities that may cause injury or infection, and follow the reconstructive surgeon’s instructions carefully.

Overall, Mohs reconstruction is a highly effective way to restore the appearance and function of skin after Mohs micrographic surgery. With the help of a skilled reconstructive surgeon, patients can enjoy a successful outcome and return to a normal, healthy life.

Hidradenitis surgery is a procedure that is performed to treat hidradenitis suppurativa (HS). HS is a chronic skin condition characterized by the formation of painful and inflamed lumps, or nodules, in areas with high concentrations of sweat glands, such as the underarms, groin, and buttocks. The goal of hidradenitis surgery is to remove the affected tissue and improve the patient’s quality of life by reducing pain, swelling, and infection.

There are various surgical options for hidradenitis, including incision and drainage, and excision. Incision and drainage is a simple procedure that involves making a small incision in the affected area to drain the pus and relieve the pressure, however recurrence is common, and sometimes may exacerbate the condition. Excisions, on the other hand, involve the removal of the entire nodule, including the surrounding tissue and sweat glands, which can be done through a traditional surgical incision or with minimally invasive techniques like endoscopic or laparoscopic surgery. The type of hidradenitis surgery that is best for a patient depends on several factors, including the severity and location of the condition, the patient’s overall health, and their personal preferences.

The recovery period following hidradenitis surgery varies depending on the type of procedure performed, but patients can expect to experience some pain, swelling, and redness around the incision site. It is imperative to follow any post-operative instructions provided by the surgeon to minimize the risk of infection and ensure proper healing. In some cases, skin grafts or other reconstructive techniques may be necessary to improve the appearance of the affected area. It is important to choose a skilled and experienced surgeon, follow post-operative instructions, and engage in proper wound care to achieve the best possible outcome.

Vitiligo is a skin condition that results in loss of skin pigmentation and hence, white patches on the skin. It can affect any part of the body and has no known cure. There are surgical options available for the treatment of vitiligo, with the goal of restoring skin pigmentation and improving the appearance of affected skin.

The melanocyte transplantation technique involves transplanting the cells responsible for skin pigmentation, from a donor area of the body to the affected area. This can be done through a skin graft or by implanting melanocyte-rich tissue directly into the affected area. This technique is generally considered effective for larger areas of depigmentation.

Scar revision surgery is a type of plastic surgery that aims to improve the appearance of scars caused by injury, trauma, or previous surgeries. Scar revision surgery can be performed on any part of the body, but is commonly done on the face, neck, arms, legs, and torso. The primary goal of scar revision surgery is to minimize the appearance of scars and make them less noticeable. There are several techniques that can be used for scar revision, including:

• Surgical excision: This involves removing the scar and then closing the wound with stitches. This technique is often used for raised or thick scars.
• Z-plasty: This is a technique that involves making a series of small incisions around the scar to reposition it and make it less noticeable.
• Laser therapy: This involves using a laser to smooth out the scar.
• Injections: Steroid injections can help reduce inflammation and improve the appearance of raised scars.

The appropriate technique will depend on the type, size, location and age of the scar, as well as the patient’s individual needs and expectations. Recovery time varies depending on the technique used. It’s important to note that while scar revision can improve the appearance of a scar, it may not completely remove it, and new scars may form during the healing process.

One of the most common uses of scar revision surgery is in the reconstruction of burn scars. Burn injuries can cause significant physical and emotional distress, and often result in permanent scars. Scar revision surgery for burn scars may involve a variety of techniques, including skin grafting, tissue expansion, and dermabrasion. The type of scar revision surgery used will depend on the location and extent of the burn, as well as the individual’s skin type and overall health.

Surgical Techniques

The surgical techniques used in scar revision surgery will vary depending on the type and location of the scar, as well as the patient’s overall health and medical history. Some common techniques include skin grafting, where healthy skin is taken from one part of the body and transplanted to the affected area; tissue expansion, where a balloon-like device is placed under the skin to stretch it and allow new skin to grow; and dermabrasion, where the surface of the skin is removed using a rotary tool to smooth out the scar.

Postoperative Care

After scar revision surgery, it is important for patients to follow their surgeon’s postoperative instructions carefully. This will typically include rest, elevated positioning, and careful wound care to promote healing and minimize the risk of complications. Most patients can return to their normal activities within a few weeks after scar revision surgery, but some may need to avoid strenuous activity or exposure to sunlight for a period of time. The ultimate goal of scar revision surgery is to help patients feel more confident and comfortable in their appearance, and to minimize the impact of scars on their daily life.

Ectropion is a condition where the lower eyelid turns outward, causing irritation, dryness, and excessive tearing. Ectropion repair is a surgical procedure that aims to correct this condition by repositioning the eyelid back to its normal position.

The procedure involves making incisions on the lower eyelid and removing a small amount of tissue to tighten the lid and pull it back into its proper position. In some cases, a skin graft or other tissue may be used to help support the eyelid and prevent future drooping.

Ectropion repair is typically performed on an outpatient basis, using local anesthesia, and patients can usually return home the same day. Recovery time varies, but most patients are advised to avoid strenuous activities and heavy lifting for several weeks after the procedure. Ectropion repair can help to alleviate discomfort and improve the function and appearance of the eye.