What we do

Mohs micrographic surgery is the most precise way to remove a skin cancer. Pioneered by Dr. Frederick Mohs and refined over nearly a century, it is today's gold standard for treating most skin cancers: the tumor is removed one thin layer at a time, and every margin is read under the microscope before you go home.

What sets Mohs apart is simple. Instead of removing a margin of healthy skin and waiting days for a lab to report whether the edges were clear, your surgeon examines 100% of the margin under the microscope while you wait. If any cancer remains, its exact location is mapped and only that spot is removed — the cancer is traced to its roots, and nothing healthy is taken unnecessarily.

Done properly, Mohs requires a fellowship-trained surgeon, dedicated laboratory staff, and an on-site laboratory where your tissue is frozen, sectioned, stained, and read within the hour it is removed. This practice is built around exactly that. The stages of a Mohs day take time because the microscope — not estimation — decides when your surgery is finished.

The result is the treatment's defining combination: cure rates up to 99% for previously untreated cancers, the most healthy skin preserved, and an answer before you leave that the cancer is gone.

• Up to 99% cure rate for previously untreated cancers
• Tissue-sparing technique preserves maximum healthy skin
• Complete microscopic examination during surgery
• Same-day results - know cancer is gone before you leave
• Optimal cosmetic outcomes with minimal scarring
• Performed as an outpatient procedure in our own facility

The procedure, step by step

1. 1.Evaluation & MarkingThe visible tumor is identified and the surgical site is prepared. Reference marks are made on the skin.
2. 2.AnesthesiaLocal anesthesia is administered to numb the area. You remain awake and comfortable throughout.
3. 3.Tissue RemovalThe visible tumor is surgically removed along with a thin layer of surrounding tissue.
4. 4.Mapping & ProcessingThe tissue is color-coded, mapped, and processed in our on-site laboratory.
5. 5.Microscopic ExaminationThe surgeon examines 100% of the tissue margins under the microscope for cancer cells.
6. 6.Repeat if NeededIf cancer remains, only the affected area is removed. This process repeats until all cancer is gone.
7. 7.ReconstructionOnce cancer-free, the wound is repaired using the most appropriate technique for optimal results.

Skin cancers we treat

From the most common cancers to rare and locally aggressive tumors.

Basal Cell Carcinoma (BCC)

The most common skin cancer, typically appearing on sun-exposed skin as a pearly bump, a pinkish patch, or a sore that heals and returns. It grows slowly and rarely spreads, but left untreated it is locally destructive — Mohs surgery removes it with the most tissue spared.

Squamous Cell Carcinoma (SCC)

The second most common skin cancer, often a firm red nodule or a scaly, crusted patch that grows or bleeds. Unlike BCC it can occasionally spread, which makes timely treatment important; high-risk tumors here get immunostained margin control in our own laboratory.

Melanoma / Malignant Melanoma (MM)

The most serious common skin cancer, arising from the skin's pigment cells — watch for a mole that changes, has irregular borders, or stands out from the rest. For appropriate cases we perform same-day, margin-controlled Mohs surgery with MART-1 and SOX10 immunostains.

Sebaceous Carcinoma

A rare, aggressive cancer of the skin's oil glands, most often on the eyelids of older adults, where it can masquerade as a stye or chalazion that never resolves. Margin-controlled excision is central to treating it well.

Dermatofibrosarcoma Protuberans (DFSP)

A rare cancer that begins in the deeper layer of the skin as a firm, slowly enlarging plaque or nodule. It sends out root-like extensions well beyond what the eye can see, which is exactly the problem margin-controlled surgery was built to solve.

Atypical Fibroxanthoma (AFX)

A rare tumor of heavily sun-damaged skin, usually on the scalp, ears, or face of older patients. It typically behaves locally, and complete margin-controlled removal is the standard of care.

Microcystic Adnexal Carcinoma (MAC)

A rare, slow-growing cancer of the sweat-gland structures, most often around the lips and central face. It infiltrates far more widely and deeply than it appears on the surface, making complete margin examination especially valuable.

Extramammary Paget's Disease (EMPD)

A rare, slow-growing cancer of apocrine-gland-rich skin, typically in the genital or perianal area, that often looks like a stubborn rash or eczema for years before diagnosis. Its edges are indistinct, so margin-controlled surgery earns its keep here.

Common questions

For anything else, call the office — you will reach a person, not a phone tree.

The same on-site immunostaining capability is applied to aggressive non-melanoma tumors, including high-risk squamous cell carcinoma. Cancers that are difficult to see on routine sections can be traced accurately to their margins, which makes them amenable to tissue-sparing surgery with higher cure rates.

• High-risk squamous cell carcinoma
• Same-day, on-site processing
• Margin control for poorly-defined tumors

Pilonidal disease — pilonidal cysts and pilonidal abscesses — arises in the natal cleft, the crease between the buttocks near the tailbone, where hair and debris work under the skin and form infected pockets and sinus tracts. It most often affects young adults, and it tends to come back when treated with drainage or simple excision alone. We treat it with the Bascom cleft lift, the current gold standard for cure: the sinus tracts are removed, the cleft is flattened, and the closure is moved off the midline where skin heals reliably. Success rates in large published series run 95 to 97 percent, and patients are typically left with a smaller, off-midline scar and a faster return to normal activity than with traditional wide excision.

• Pilonidal cysts, abscesses, and sinus tracts — including recurrent disease
• Bascom cleft lift: the gold standard for cure
• Success rates of 95–97% in large published series
• Off-midline closure, where wounds heal more reliably
• Alternative to wide excision and open healing

Hair loss is a medical problem before it is a cosmetic one, and we treat it that way. Evaluation starts with a physical and clinical examination and, where indicated, laboratory testing — because thyroid disease, iron deficiency, and other medical causes need to be found, not covered up. Treatment is then built holistically from the tools with evidence behind them: oral medications, topical medications, and platelet-rich plasma (PRP) — your own concentrated platelets injected into thinning areas over a series of sessions. PRP is one tool in a complete plan, not the whole plan.

• Physical and clinical examination of the scalp and hair
• Laboratory evaluation where indicated
• Oral and topical medical therapy
• Platelet-rich plasma (PRP) injections
• A complete, medical approach — not PRP in isolation