Skin cancer
Caught early, it is usually a one-day problem.
Mohs micrographic surgery has the highest cure rate for the common skin cancers, and it removes the least healthy tissue to get there.
South Orange County is a hard place to keep your skin out of the sun, and basal cell and squamous cell carcinomas are the ordinary consequence. Ordinary is not the same as safe: they keep growing, and the longer they grow the more of your face the repair involves.
How the appointment works
The examination
Somebody looks at the spot, and at the rest of you. If it needs a biopsy, that is done here, usually at the same appointment.
The day of surgery
You come in, the area is numbed, and the visible cancer is removed. You wait in the office — bring a book; this is the long part.
Reading the margins
The tissue is mapped and examined under a microscope in the building. If any cancer remains, only that part is taken, and it is checked again.
Closing up
Once the margins are clear, Dr. Lander repairs the wound. Reconstruction is part of his fellowship training, so it happens in the same room, on the same day.
Questions we get asked
Will I need to be referred somewhere else?
No. The excision, the microscope work and the reconstruction all happen in this office. Dr. Lander heads the Mohs department here.
How long does it take?
Plan on most of a day. Most cases are finished in one or two layers, but the honest answer is that it depends on what the microscope shows.
Does it hurt?
The area is numbed with local anaesthetic. You are awake, and you can eat beforehand — you should.
What if the spot turns out to be nothing?
Then you have paid for twenty minutes and stopped thinking about it, which is the cheapest outcome in dermatology.
Bring us the spot. We will tell you what it is.
Biopsies are done in the office. Referrals for Mohs surgery are accepted from other practices.