So I wanted to give an update on the practice and apologize for no recent updates but life is getting back into a predictable routine with our new son Jackson sleeping more every night.
Mohs Reconstruction has become a substantial component of my new practice is Austin which is great because I really enjoy performing the reconstructions. Every patient has a unique reconstructive need and although many defects can be reconstructed with standard techniques there is so much room for tweaking or artistic flair. I get to stretch my engineering muscles and also artistic eye. And better still we do it all in the office under local anesthesia and the patients don't have any anesthesia recovery, nausea, or really any significant issues.
What is Mohs surgery? Taken straight from Wikipedia
Mohs surgery, also known as chemosurgery, developed in 1938 by a general surgeon, Frederic E. Mohs, is microscopically controlled surgery used to treat common types of skin cancer. During the surgery, after each removal of tissue and while the patient waits, the tissue is examined for cancer cells. That examination informs the decision for additional tissue removal. Mohs surgery is one of the many methods of obtaining complete margin control during removal of a skin cancer (CCPDMA – complete circumferential peripheral and deep margin assessment.) using frozen section histology. CCPDMA or Mohs surgery allows for the removal of a skin cancer with very narrow surgical margin and a high cure rate.
What is Mohs reconstruction?
This is the fun part for the plastic surgeon which is to take a frequently scary open area on a highly visible location for the patient such as the face and shift the adjacent tissues, regional, or distant tissues to reconstruct the area in as cosmetically acceptable manner possible.
We have been fortunate to work closely with local Austin Mohs surgeons and coordinate care of the patient usually by consulting with the patient before the planned excision so we can go over the options with respect to whether we anticipate needing a skin graft, local flap (skin that is transferred to the defect area with intact blood supply), or distant flap. We will typically then see the patient immediately following the Mohs excision in the office and take pictures, perform measurements, and plan for the reconstruction. The vast majority of cases we will then add some additional local anesthetic that is much less painful then the initial injection by the Mohs surgeon as it is typically still numb and then perform our reconstruction. Typically the procedures will take a bit less than an hour to complete. For those patients that have areas that are a little too large to reconstruct in the office we would then replace the bandage and schedule in any of the accredited surgery center in town. Stay tuned for pre and post operative pictures in our photo gallery as our patients progress through the immediate post operative stage.