Thanks to research breakthroughs and clinical advances and instrumentation, the majority of dermatologic surgeries are now minimally invasive and require only local or regional anesthesia. These procedures can typically be performed in our office. This translates into superior patient safety while reducing the all-important "downtime" and recovery period.
This procedure is used to remove both benign and malignant skin growths. Excisional surgery can be performed to remove some skin cancers. Following the procedure, the specimen is examined by a dermatopathologist under a microscope to ensure that the growth has been removed completely. Excisional surgery is also used to remove benign growths, such as atypical moles and cysts. It is typically performed under local anesthesia, in our office.
Most procedures take approximately 30 minutes to complete. After numbing the area and cleansing the site with a surgical disinfectant, our staff will painlessly remove the growth. The area is then re-constructed using sutures (stitches). Most stitches stay in place for 1-2 weeks. Of course, every patient and procedure is different. We will explain each procedure to you in detail before it is performed. Most patients can return to work and their daily activities the same day.
Mohs Micrographic Surgery for Skin Cancer
Mohs Micrographic Surgery, an advanced procedure for the precise removal of skin cancer, is performed in our office. There are a number highly effective options to treat skin cancers, including excision and suturing, curettage and electrodessication (scraping and burning), cryosurgery, radiation therapy, photodynamic therapy, and Mohs Surgery. With careful examination and a thorough exploration of your options, we will customize a plan to help you successfully control or remedy your problem.
Mohs Micrographic Surgery is primarily used to treat some basal cell and squamous cell carcinomas. It allows the physician to see beyond the visible disease, to precisely identify and remove the entire tumor, layer by layer, while leaving the surrounding healthy tissue intact and unharmed. As the most exact and precise method of tumor removal, it minimizes the chance of re-growth and lessens the potential for extensive scarring or disfigurement.
Because the physician is specially trained in surgery, pathology, and reconstruction, Mohs surgery has the highest success rate of all treatments for skin cancer - up to 99 percent. The Mohs technique is also the treatment of choice for cancers of the face and other sensitive areas as it relies on the accuracy of a microscopically-controlled surgical procedure to trace the edges of the cancer and ensure complete removal of tumors, down to the roots, during the initial surgery.
After the tumor has been completely removed, your physician will discuss closure options with you to reconstruct the wound. Most wounds are closed with sutures (stitches). Most small wounds can be closed with a side-by-side closure (linear closure with stitches). Some larger wounds require a skin flap where skin adjacent to the wound is "borrowed," or a skin graft. Some wounds heal best by spontaneous granulation, where the wound is allowed to heal naturally. Every case is different and will be discussed with you in detail.
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David A. Kiken, M.D., FAAD, Mohs Surgeon
A native of New Jersey, Dr. Kiken graduated from the University of Pennsylvania summa cum laude and received his Bachelor of Arts in Biology, with distinction, earning membership in Phi Beta Kappa. He received his medical degree from New York University School of Medicine, after which he completed an internship in internal medicine at Lenox Hill Hospital in New York.
Dr. Kiken then pursued a clinical research fellowship in Pediatric Dermatology at St. Luke's Roosevelt Hospital. He continued his dermatology training and served as Chief Resident of Dermatology in his final year of residency, at the University of California, San Diego, where he received extensive training in advanced dermatologic and skin surgery techniques.
Dr. Kiken is a fellow of the American Academy of Dermatology and the American Society of Dermatologic Surgery. He is also a member of the American Society of Cosmetic Dermatology and Aesthetic Surgery and the National Psoriasis Foundation.
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