Like most board certified plastic surgeons, my practice includes both cosmetic surgery and general plastic surgery, such as breast reconstruction, skin cancer removal, and other types of reconstruction. Patients wonder why plastic surgeons do both cosmetic and reconstructive surgery, and it has to do with the history of the specialty and the way we are trained to handle tissue. I have always preferred a diversified practice, helping patients with elective wishes to improve their appearance, but also to help patients with very serious medical problems such as malignant melanoma, squamous cell and basal cell carcinoma.
Our ongoing study of 250 of my patients continues to show the highest cure rates for basal cell carcinoma. My patients have a 99.6 % rate of cure when followed for 5 years or longer.
Similar to the Mohs technique, I remove the cancer one layer at a time and initially remove only about 1-2 mm around the border of the lesion. I use microscopy to remove the cancer.
With the Mohs technique, the doctor removing the tumor or cancer must, by definition, be the same doctor who looks at it under the microscope. Unlike the Mohs technique, I do not look at the pathology slides myself but instead give the removed tissue to a very experienced pathologist while I stay with the patient. The pathologist looks at the tissue after sectioning it with either a tangential, serial, or a combination of both techniques. This way the minimum of tissue is removed resulting in a scar as small as possible.
During the surgery, the pathologist and I are in continuous consultation to ensure the most complete removal. Then, I use plastic surgery to repair the area for the best cosmetic result. Patients often prefer intravenous sedation. I also only operate on one patient at a time. These are considered to be advantages over the Mohs technique, which also has a very high cure rate.
For the uncomplicated skin cancer, we feel we offer the highest rates of cure with the smallest amount of tissue removal and the advantages of a cosmetic surgical repair.
If you have a skin cancer and would like plastic surgery for the best appearance and using the technique described above for an excellent rate of cure, please call the office and schedule a consultation.
Dr. Joe Rabson