Lip Cancer Question- Re MOHS and DR Qualifications.

my dad needs squamous remover from his lip. about 2 cm. is it best to go with derm or plastics to do this? I have been referred to a DR who is a derm but has experience in reconstruction. since it is the face I want to be sure.

Doctor Answers 5

Mohs surgery with plastic surgery reconstruction

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An oft used ideal approach for skin cancer on the lip is Mohs surgery to remove the tumor and then a plastic surgeon to minimize the scar associated with reconstruction.

West Palm Beach Dermatologic Surgeon

Who should remove your skin cancer and who should reconstruct the defect left after removal?

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Who should remove your skin cancer and who should reconstruct the defect left after removal?

Definitely for a moderately sized upper lip skin cancer, Mohs is the best option for complete removal of the tumor and preservation of as much normal skin as possible. The vast majority of Mohs surgeons are dermatologists but seek a Mohs surgeon who also has fellowship training in Mohs surgery. These surgeons are also typically highly trained in reconstruction.

Review photos of your Mohs surgeon's results . If you're not happy with the cosmetic results, ask if they can refer to a Facial Plastic Surgeon or Plastic Surgeon for reconstruction.

Stephen Weber MD, FACS

Skin Cancer on the Lip: Mohs vs. Plastics

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In my opinion Mohs surgery will give you the best opportunity to cure the skin cancer. Mohs surgery works by tracing out the roots of the skin cancer. When a skin cancer invovles an area with a limited amount of tissue for reconstruction (like the lips,ears, eyelid or nose), Mohs is a good option because the surgeon starts with a very narrow margin. Thus, the tumor is traced out but the healthy tissue is preserved. Also, a squamous cell carcinoma can be a dangerous skin cancer on the lip especially if it recurs. Through properly performed Mohs surgery, the chance of recurrence is very low. I would recommend that you speak with a member or fellow of the American College of Mohs Surgery. These individuals have completed fellowships in Mohs surgery (including Mohs surgery, reconstruction and interpretation of pathology slides) beyond their residencies. The reconstruction can likely be performed by one of these fellowship-trained Mohs surgeons or, if you prefer, they can arrange to have another doctor (e.g. plastic surgeon) perform the reconstruction after the cancer is removed. Good luck.

Andrew Kaufman, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 16 reviews

Fellowship Tranined Mohs Surgeons Are Trained In Reconstructive Surgery

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There are many physicians that perform Mohs surgery, but not all have the qualifications and have completed a fellowship training program. As a dermatologist who has completed a fellowship in Mohs surgery sponsored by the American College of Mohs Surgery, I can tell you that a fundamental part of my training centered around reconstructive surgery. During my fellowship I completed over 2000 reconstructive surgeries for skin cancers primarily found on the face. This included areas such as the nose, lips and eyelids. I have continued to perform all of my reconstructive surgeries since I started my practice. Fellowship trained Mohs surgeons are highly qualified surgeons capable of the most advanced surgical reconstructive techniques. I don't think your dad can go wrong with this type of doctor. My recommendation is to check the American College of Mohs Surgery website to find a qualified physician near you.

Adam J. Mamelak, MD
Austin Dermatologic Surgeon

Derms or plastic surgeons and Mohs

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I have been a dermatologist for nearly 30 years and have been Mohs trained and board certified. I have done  tens of thousands of Mohs in my career. I have done extensive reconstructions and repairs. Not all Mohs surgeons have done this much, but many have. You can look at the American Society for Mohs Surgery website to see who in your area is board certified by them. That's a good place to start. You can also ask the doctor whom you were referred to. Most qualified physicians aren't going to take on cases we can't do or don't have experience in, and most good physicians would be willing to tell you this. I don't think it matters if it's a plastic surgeon or a dermatologist - as long as your dad sees someone who is trained in Mohs - the largest part of this procedure is doing complex repairs and reconstructions and minimizing scarring, but yet, most importantly, removing the cancer!

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.