I am a plastic surgeon in practice for 23 years. I am a patient of and have referred patients to Dr. Anne Walter. I have been very impressed with her knowledge and the caring manner with which she treats her patients. She takes on difficult clinical problems with confidence. While her office is very busy because of the excellent care the team provides, her staff is welcoming and kind. I do not believe you can find a better office for your dermatologic needs in Scottsdale.
Dr. Walter at Dermatology and Skin Surgery Specialists was absolutely wonderful. She treated my face, neck and chest and also included my hands for free. My skin was damaged due to years of sun damage and tanning bed use. My daughter was getting married so I wanted to look my best. Dr. Walter spent a generous amount of time explaining the procedure to me. The day of the treatment, they used topical numbing and a cool air device. I have heard how painful the procedure can be, but I barely felt it. I was red and crusty for about 7 days, but by the end of a week, I could cover it with makeup. Over the past two months, my skin keeps looking better and better! I highly recommend seeing Dr. Walter for Fractional CO2 treatment.
Great question! This is a question that comes up frequently in my practice. Both Mohs and standard excision can be used to effectively treat skin cancers. In standard excisions, the visible skin cancer is removed along with a 4-8 mm margin of healthy appearing tissue. The wound is then stitched closed. The tissue is then send out for the margins to be checked over the next few days. When the pathologist looks at the tissue, they use a method called “bread loafing” where the pathologies makes slices through the tissue and examines those margins as a representative sample to determine that the margins are clear. In Mohs surgeries, the visible cancer is removed along with a narrow rim of healthy tissue. The tissue is then processed while the patient is waiting in the clinic. During the processing, the edges are laid down in order to examine 100% of the margins. It is helpful to compare the Mohs layer of tissue to a pie. The processing lays down the crust (tissue edges) to make sure there is an intact layer of crust (healthy skin) separating you from the pie filling (or your skin cancer). If residual cancer is found, then another layer is taken but only if the areas where cancer was seen and the rest of the healthy tissue is left alone. This method has the highest cure rate, with the smallest amount of tissue removed. Once the cancer is cleared, then the wound is stitched closed. Mohs surgery is a more time consuming and more costly treatment option that is used for areas where tissue conservation is important. These areas include the face, scalp, neck, hands, feet, genitals and shins. You should always feel comfortable asking your board certified dermatologist to explain further details about each treatment option and why they specifically recommended that option for you.
