Mohs surgery, Flaps and Grafts, Rhinophyma and Dermabrasion

Mohs micrographic surgery is a meticulous technique in the removal of cancerous skin tumors such as basal cell carcinoma, squamous cell carcinoma, melanoma in situ, merkel cell carcinoma, dermatofibrosarcoma, sebaceous carcinoma and atypical fibroxanthoma, among others. The Mohs surgeon is both the pathologist and surgeon. He or she examines 100% of the specimen under the microscope. The tumor is excised until margins are negative. The procedure can take from 2 hours to a whole day depending on the roots that are seen microscopically. The goal is complete removal.

Flaps and Grafts are repair techniques used to close a surgical defect when it is no longer cosmetically acceptable to do so with primary closure. With flaps, adjacent tissue is moved to the defect. With a graft, skin in taken from an area far from the defect. This requires both good surgical technique and an artistic eye.

Rhinophyma is a skin condition wherein the nose skin is thickened. This can be genetic. The skin may be corrected using such techniques as dermabrasion and laser.

Dermabrasion is a clinic-based procedure that involves using an electronic motorized handheld machine with a diamond fraise. The skin is abraded at two layers: epidermis and dermis. The goal is to make the skin smoother.

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