Mohs Surgery

March 28th, 2013 Posted in Mohs Surgery
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Despite more public awareness about skin cancer and what causes it, an estimated two million people are diagnosed with some type of skin cancer each year in the United States. And according to the Skin Cancer Foundation, one person dies every hour from melanoma, the most deadly form of skin cancer. 

Despite those high numbers, it is also true that most skin cancers, the more common basal and squamous cell cancers, have a very high cure rate if diagnosed and treated early. In fact, the primary surgical procedure to remove skin cancer, Mohs surgery, is credited with curing 99 percent of initial cancers and 95 percent of recurrent cancers, including even some melanoma. 

In a nutshell, Mohs surgery, developed in 1930 by Dr. Frederic Mohs, is a form of micrographic surgery in which the surgeon removes tissue, maps it with a microscope and then determines where to cut next. The procedure is repeated until all traces of the cancer are removed, and the maximum amount of healthy tissue is preserved. 

Mohs surgery, however, usually results in scarring and deformities in aesthetic areas like the face and neck. So, reconstructive surgery is often needed. Sometimes, this is done by the Mohs surgeon – usually a specially trained dermatologist – and sometimes, by a separate Mohs plastic surgeon. 

One drawback with Mohs surgery is that the procedure is sometimes lengthy. It is usually done on an outpatient basis under local anesthetic, as the patient waits. The process of cutting and mapping can take an entire day, depending on how much cancer is found. This obviously requires a lot of patience on the part of the patient, and a great focus on the part of the Mohs surgeon.

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Sunscreen 101

March 28th, 2013 Posted in Skin Rejuvenation
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You probably already know that wearing sunscreen is the single most important thing you can do to protect your skin from skin cancer, not to mention wrinkles, sagging and other signs of premature aging. Skin resurfacing can repair most sun damage, but you can prevent sun damage by wearing the right sunscreen. 

New products on the market give you more choices than ever. Traditionally, sunscreens are chosen based on their SPF rating, but SPF only addresses protection against UVB rays, the ultraviolet rays that cause sunburn. To get a product that protects you against UVA rays – the deep penetrating rays that cause wrinkles – you need to look at the label for these ingredients: zinc oxide, ecamsule or avobenzone. 

As far as the SPF rating, it depends largely on skin type: 

Normal Skin – If you have normal skin, sunscreen with a rating of SPF 15 should suffice. It should be noted that higher ratings do not necessarily translate into much greater protection. In other words, while 15 SPF filters out 93 percent of UVB rays, 30 SPF filters out about 97 percent – not a dramatic increase. 

Sensitive Skin – Those with an increased sensitivity to sunlight include children, those with very fair skin and anyone who’s had cosmetic surgery. People in this category should use an SPF rating of 30 or higher.  

When applying sunscreen, don’t skimp. Use a generous amount and apply on every area that is exposed to the light. Reapply every two hours, or more often if you are doing sports. Remember to re-apply sunscreen immediately after swimming. Most of all, try to avoid staying out in the sun during the noontime hours, as this is the time the sun’s rays can do the most damage to your skin.

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What is Liposculpture?

March 7th, 2013 Posted in Cosmetic Surgery
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While most people are familiar with liposuction, a surgical procedure in which fat is literally vacuumed from the body, they may not have heard of its cousin, liposculpture. Liposculpture is a less invasive technique used by plastic surgeons to remove targeted areas of fat from under the skin to provide a more sculpted, younger look. 

How is it done?  

Developed in the late 20th century by doctors in Europe and Australia, liposculpture uses a technique called the tumescent technique. In this process, the doctor injects a saline solution in the targeted area, which numbs the area and liquidizes the fat to make it easier to remove. The fat is then removed with a small vacuum device. 

What parts of the body can be liposculpted? 

Even with diet and exercise some areas of fat remain stubbornly in place in the neck, cheeks, upper abdomen, buttocks, calves and ankles. Liposculpture can reduce the chubby appearance caused by this excess fat and help bring definition to the treated areas. 

How long is recovery from liposculpture? 

One reason liposculpture is so popular is that it is usually done on an outpatient basis. Patients can typically drive home after the procedure, and recovery takes just several days to a week. Patients can experience swelling and bruising, and sometimes fluid can leak from the injection site. Pain is mild to moderate. 

Are there any risks? 

As with any surgical procedure, there is always the risk of infection or allergic reaction.  Also, depending on your age and the level of collagen in your skin, the skin may not always tighten properly over the treated area, resulting in sagging.

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Skin Resurfacing: One Goal, Many Options

March 7th, 2013 Posted in Laser Skin Rejuvenation
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Do you long for smoother, clearer, younger looking skin? Fortunately for you, the fountain of youth really does exist – to a degree – right in the offices of your local plastic surgeon.  Modern skin rejuvenation procedures can produce remarkable results, taking years off your appearance without the need for costly plastic surgery or long recovery times. 

There are a number of options available for skin rejuvenation, also called skin resurfacing. They fall into several groups: 

Superficial Peels –  Superficial peels include those using glycolic acid, lactic acid or salicylic acid. Such peels work by removing the very outer layer of the skin, allowing the newer, fresher cells to come to the surface. Some may experience redness and tingling during and immediately after the peel, but there is generally no down time associated with these types of peels. 

Medium/Deep Chemical Peels –  Jessner solution and TCA, or Trychloroacetic acid, are considered medium chemical peels, while a Phenol acid peel is considered the strongest. The results for these peels are more dramatic and longer lasting, but there is more down time. Phenol peels can take seven to 10 days for recovery, with swelling, redness and pain. Skin remains sensitive for awhile, and sunscreen is an absolute must. 

Traditional and Fractional Laser Therapy –  Laser resurfacing uses intense light to treat wrinkles, sun damage and other signs of aging. The two main types are CO2 and erbium. CO2 produces the most dramatic results, but also requires the longest healing times. Erbium tends to be more gentle and have a quicker recovery time. All forms of laser skin resurfacing produce a certain amount of redness and swelling. Healing can take a number of months, but the results can last for years. Laser therapy can be much more costly compared to other procedures, sometimes costing thousands of dollars. 

Dermabrasion –  With dermabrasion, the cosmetic surgeon or dermatologist uses a small rotating brush to remove the damaged outer layers of the skin. Swelling and bleeding can occur, and recovery can take weeks to several months. Lasers have largely replaced dermabrasion as a skin resurfacing technique, but dermabrasion is still used to treat targeted areas such as acne scars or small lines and wrinkles around the mouth.

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