SURGICAL

DERMATOLOGY

Surgical Services

 


SKIN CANCER & MOHS surgery

The most common cancer in humans is skin cancer. 1 in 5 Americans develop skin cancer in their lifetime, and it can develop at any age, from your childhood or teen years to your senior years.

The Skin Cancer Foundation recommends that everyone sees their physician every year for a professional skin exam. After a diagnosis of skin cancer is confirmed by biopsy, there are several treatment options to cure skin cancer.

Depending on the type of skin cancer diagnosed, most can be surgically excised with a wide local excision or with a special type of tissue-sparing surgery calls Mohs surgery. Other methods to treat skin cancer include: removing with a procedure called ED&C (electrodessication and curettage) or radiation treatments to the skin. Only in advanced in cases of skin cancer are chemotherapy and lymph node removal indicated.

Mohs Micrographic Surgery is a technique to remove skin cancers from areas that are cosmetically important. It is a specialized, highly effective technique developed by Dr. Frederic E. Mohs in the 1930s for the selective removal of skin cancer. This technique differs from other skin cancer treatments in that it allows for complete removal of the skin cancer including its “roots” with the aid of a microscope, while preserving as much of the normal surrounding tissue as possible.

For example, a skin cancer on the nose is a common problem but removing a lot of tissue from the nose can cause disfigurement and an unnecessarily large scar. Using the Mohs technique, the dermatologic surgeon can remove only the cancerous tissue and also verify that all the cancer cells are removed by inspecting the tissue under the microscope during the actual surgery. The Mohs surgeon excises individual layers of the cancer and follows the positive margins with the microscope as the guide. This way only cancerous tissue is removed and "chased" so that the smallest possible excision is created but the highest cure rate is achieved.

Most skin cancer is cured with a standard surgical excision but facial and recurrent skin cancers are excised via Mohs Surgery. Due to the meticulous manner in which the tissue is removed, mapped, and microscopically examined, Mohs micrographic surgery yields the highest cure rate.



EYELID SURGERY - (BLEPHAROPLASTY)

Whenever we communicate with others, they are looking mostly at our eyes and mouth, the main focal points of communication. It makes sense that these areas should be the most aesthetically pleasing and youthful.

Just as a great smile with healthy bright teeth is a sign of beauty and health, the appearance of our eyes is a major youth or age-revealing factor. The skin around our eyes is among the thinnest on our entire body. Drooping or hanging eyelid skin can make us look old beyond our years.

Often, normal parts of the aging process, like wrinkling, sagging, and hanging skin, can affect this tissue prematurely. Men and woman as early as 40 years old begin to show droopy upper eyelids. An upper eyelid surgery, called a Blephroplasty is a minimally invasive procedure that can make you look 10-15 years younger.

We perform this surgery in our office in less than two hours. Our patients are kept comfortable under local anesthesia and experience little to no pain at all. After the surgery, patients go home with little to no bruising. The procedure is scarless because the natural folds and lines of your eyelid are used, so no new lines are formed by the surgery.

Eyelid surgery is an extremely delicate skin procedure that requires precision, accuracy and artistry. Only the right amount of skin should be removed. Excessive skin removal leaves patients with a hollow, surgical appearance. Dr. Gabriel uses refined procedures that prevent this mistake, ensuring her patients look natural and refreshed. The surgery procedure is nearly painless, has little downtime and when done correctly can have the greatest impact on the youthfulness of your face.

Dr. Zena Gabriel was trained on eyelid surgery at the Jules Stein Eye Institute in the Department of Ophthalmology at UCLA. Her expertise in skin cancer repair and cutaneous surgery makes her uniquely equipped to repair the fragile skin of the eyelid.


LUMPS & BUMPS

The skin is a dynamic tissue that grows many “lumps and bumps.” Pimples are the most common “bumps” on the skin. But there are many other types of growths that commonly grow on the skin.

LIPOMA

These are common benign “fatty tumors” that are soft and mushy. They grow slowly and are painless. Sometimes they appear in awkward locations and make people self-conscious. A small excision with local numbing medicine is an easy way to eliminate lipomas.

CSYTS

Cysts are very common, benign skin growths that sometimes have a head or opening to the surface. They can get infected or inflamed and cause pain. Many people have cysts beneath the skin with no inflammation or tenderness. They often think they can pop a cyst and get rid of it. However, true cysts have a lining and squeezing the contents out will not resolve it. This lining must be removed. It’s important not to poke at, pop, or irritate a cyst because this can cause it to burst, become infected and create a scar. Cysts are easily removed with a small excision.

WARTS

Warts are common skin growths caused by a virus in children and adults. There are many ways to treat warts, but our office is dedicated to eliminating warts at your first visit. All too often, warts are treated by freezing the growth which requires multiple painful treatments. We believe warts are annoying to most people and they want them resolved quickly. Our protocol is to numb the area and eradicate the wart completely at your first visit with combination therapy.

MOLES

Not all moles are dangerous or cancer prone. Some moles are simply cosmetically undesirable. We can remove moles without scar formation by shaving it flush with the surface (if it is flesh-colored), or, if it is brown or pigmented, by excising the mole with the core. A simple mole removal from the face can make a big difference in cosmetic appeal or gratification.