If you have been diagnosed with skin cancer, your doctor may recommend a procedure called Mohs Micrographic Surgery followed by reconstructive surgery by a plastic surgeon. Vanguard Skin Specialists is the only practice in Southern Colorado where Mohs surgeons and plastic surgeons work together in the same office to offer comprehensive treatment of skin cancer with the best cosmetic result.

Why is Mohs Micrographic Surgery the preferred treatment?

There are several options for treating skin cancer, and Mohs Micrographic Surgery is recommended for non-melanoma skin cancers if skin cancer is aggressive, recurrent, or located in a cosmetically or functionally sensitive area.

Mohs surgery was initially developed by Dr. Frederic E. Mohs and has been refined over the past 70 years. It is the most effective procedure for treating basal cell and squamous cell carcinoma, with the highest cure rate of all skin cancer treatments – up to 99%. This technique enables surgeons to identify and remove tumors one layer at a time while preserving as much of the healthy tissue as possible. A diagram illustrating this layering process is here.

This type of surgery can be performed by any dermatologist, but at Vanguard Skin Specialists, only dermatologists who have completed a surgical fellowship in Mohs Micrographic Surgery will perform this service. It is because we believe a physician should complete the highest level of training in a field before offering that medical service to patients. Surgeons with this distinction are members of the American College of Mohs Surgery, and at Vanguard, our fellowship-trained Mohs surgeons include Dr. Vinh Chung and Dr. Renata Prado.

How does a Mohs surgeon work with a plastic surgeon? 

Vanguard’s Mohs surgeons have undergone rigorous training in reconstruction after Mohs surgery, and they have collectively treated and repaired tens of thousands of skin cancers. There are instances, however, when it may be appropriate or preferred for a plastic surgeon to handle the reconstructive surgery.

The most common instances when Vanguard’s Mohs surgeons and plastic surgeons work together are the following:

• Mohs micrographic surgery is the recommended treatment when skin cancer is in an area that is cosmetically or functionally sensitive, so achieving the best cosmetic result is important. A plastic surgeon may have expertise in the reconstruction of a particular anatomic region.
• Mohs micrographic surgery is the recommended treatment when skin cancer is aggressive, so the defect may be large, requiring complex reconstructive options including but not limited to reconstructing cartilage or staged reconstructive surgeries.
• In some instances, repairing the defect may require that the reconstructive surgery take place in an operating room under general anesthesia. Mohs surgeons work in an office setting and perform surgeries under local anesthesia. If a surgery center is required, Vanguard’s plastic surgeons will perform the skin cancer reconstruction.
• Some patients prefer having a particular plastic surgeon reconstruct a defect, so we will honor their requests.

Vanguard’s plastic surgeons are highly trained, and they include facial plastic surgeon, Dr. David Archibald, and general plastic surgeon, Dr. James Banich.

What is the surgery process? 

Vanguard is the only medical practice in Southern Colorado with both dermatologists and plastic surgeons regularly working side-by-side.  We are able to offer skin cancer treatment by a Mohs surgeon and cosmetic reconstruction by a plastic surgeon on the same day in the same facility. Our focus is highest cure rate, best cosmetic result, with convenience to our patients.

Upon arrival, you will be taken to a surgical room and your Mohs surgeon will surgically remove the skin cancer. This may take multiple stages, and it is difficult to know in advance how many stages are required because skin cancer can extend beyond what is visible. But throughout the Mohs process, you will remain in the same room so that you can be comfortable and have privacy. Even before the COVID-19 pandemic, we assigned patients private rooms to maximize safety and comfort, and during this season, this safety and privacy measure has been particularly important.

Once your Mohs surgeon has cleared the skin cancer, you will move down the hall to the plastic surgeon’s suite. Depending on the size and location of the defect following Mohs surgery, your plastic surgeon will discuss and recommend the best reconstructive option for you. In most cases, the reconstruction will take place in the office. In certain instances, your surgeon may recommend reconstruction in an operating room at a later date.

Vanguard Skin Specialists provides this multidisciplinary approach in treating skin cancer at the Colorado Springs Briargate, Colorado Springs Broadmoor, and Pueblo offices.

Vanguard Skin Specialists believes medicine is a team sport where doctors who are experts in their respective fields should work together to achieve the best patient outcome. Our Mohs and plastic surgeons are dedicated to providing the best cure rate with the best cosmetic outcome, and with that, we hope our skin cancer patients can have peace of mind.

To learn more or to schedule an appointment, call 719 355 1585.

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