I have just been diagnosed with squamous cell carcinoma on my scalp. The best Mohs Surgery plastic surgeon in my area can't see me until October 2. Can anyone recommend a plastic surgeon who has expertise in Mohs Surgery.
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Doctor Answers 2
Mohs surgeons are generally dermatologists, not plastic surgeons
There are different approaches to surgically treating an SCC of the scalp. Mohs surgery performed by a very skilled and officially-trained Mohs surgeon is one of the best options, and proper Mohs training does include complex repairs such as flaps if necessary.
Direct excision by a plastic surgeon is also a fine option. The downside of this technique is that with traditional pathology readings, the "permanent section" pathology slides are read AFTER the wound is closed, and as is often the case with scalp SCC's. If the margins are surprisingly wide and the lesion is not cleared, a complex area has to be reopened and operated on.
Any technique with pathologic confirmation of clear margins before closure is a valid one, whether the removal be done by a Mohs fellowship-trained dermatologic surgeon, or a conscientious plastic surgeon.
Fellowship trained Mohs surgeons can be found at www.MohsCollege.org.
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Squamous Cell Carcinoma of the Scalp
Although Moh's is an acceptable form of treatment for squamous cell carcinoma of the scalp you should also get a second opinion from a plastic surgeon about direct excision of this lesion and reconstruction with local flaps (i.e. advancement of the tissues of the scalp). You should just have the ability to understand the differences in technique as well as the length of time the procedures take as well as the potential risks and complications and the implications for alopecia (bald areas secondary to the procedures). Just get a second opinion so that you are fully informed and can the decision you feel is best for you. I am not aware of any plastic surgeon who does Moh's.
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