internal mohs

Skin cancer touches the lives of over two million Americans each year, emphasizing the need for timely intervention. The Mohs surgery technique, a highly successful treatment for non-melanoma skin cancer, boasts a remarkable cure rate of over 99 percent. Feinstein Dermatology, located in Delray Beach, FL, proudly provides this cutting-edge treatment under the skilled hands of our own Dr. Feinstein, who has performed over 10,000 Mohs procedures. Your journey to recovery begins here in our community.

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Meet Your Mohs Surgeon

Brian Feinstein, D.O., FAAD – Board-Certified Dermatologist & Board Certified Mohs Surgeon

Dr. Brian Feinstein, a Board Certified Dermatologist and Board Certified Mohs surgeon, has personally performed over 10,000 Mohs cases, setting the gold standard for precision and results. As a fellow of prestigious organizations like the American Academy of Dermatology and the American Society for Mohs Surgery, Dr. Feinstein’s expertise is widely recognized. Actively engaged in clinical trials with major pharmaceutical companies, he brings cutting-edge insights to patient care.

  • Patients’ Choice Award – 5 Years Running
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In-House Board Certified Plastic Surgeon for Reconstructive Mohs Closure

Lawrence Enisman, M.D., FACS

Our practice goes the extra mile with an on-site Board Certified Plastic and Reconstructive Surgeon that will perform your Mohs closures. Dr. Lawrence Enisman, with over three decades of experience, is exceptionally skilled in Mohs reconstructive surgery, specializing in facial reconstruction. Dr. Enisman completed his medical degree at New York Medical College and his residency at St. Vincent’s Hospital in New York City. Dr. Enisman is a Fellow of the American College of Surgeons and a Member of the American Society of Plastic Surgeons. He has served as Chairman of Plastic Surgery at St. Francis Hospital and is the past Chairman of Plastic Surgery at Vassar Brothers Medical Center.

The Advantages

Mohs surgery stands out for its minimal impact on healthy tissues and the thorough analysis of removed layers, making it the most successful cancer treatment. Additional benefits include:

  • Complete cancer removal during surgery.
  • Eliminating the risk of cancer recurrence.
  • Minimizing the loss of healthy tissue.
  • Optimizing functional and aesthetic outcomes.
  • Repairing the affected site the same day as skin cancer removal.
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Will My Insurance Cover Mohs Surgery?

Most insurance plans cover Mohs surgery costs and associated wound repair treatments. Copayments, deductibles, or coinsurance not covered by your health plan are your responsibility. Although the initial procedure may be costlier due to skilled personnel and advanced technology, the high success rate often requires only a single surgery, saving potential multiple surgery expenses associated with other methods. A single fee for Mohs surgery consolidates costs compared to separate fees for additional surgeries with alternative methods. Our team is ready to address any questions regarding insurance or financing, ensuring your peace of mind during this journey.

What to Expect Before Surgery

Unless Dr. Feinstein directs otherwise, continue your regular medications and supplements. On the surgery day, wear loose, comfortable clothing that provides easy access to the treated area. Expect a two to five-hour procedure, with breakfast or lunch provided based on your appointment time. Additionally, consider arranging for someone to drive you home after the proced


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BEFORE & AFTER PHOTOS

Mohs Surgery Transformations

The Surgery

On your Mohs procedure day, our patient care team welcomes you to a private treatment area. They will aid in taking pictures of the treatment site, asking pre-op questions, and preparing you for local anesthesia. Once comfortable, Dr. Feinstein meticulously removes cancerous skin layer by layer. After completion, your wound site is fully bandaged and dressed.

You’ll spend some time in the lobby while the tissue undergoes microscopic examination. If cancer cells persist, the process repeats until complete removal. Your doctor will then discuss the best way to close the wound, considering factors like appearance, function, and aesthetics.


Recovery After Mohs Surgery

Post-surgery, care for your wound site involves regularly changing bandages. One of our medical assistants will provide post-operative care instructions, and our team is accessible by phone for any questions.


Mohs Surgery FAQs

After Mohs surgery, most patients experience minimal discomfort, which can typically be managed with over-the-counter pain relievers such as Tylenol. However, it’s important to avoid aspirin or aspirin-related products like Motrin, Advil, Aleve, or ibuprofen, as they can increase the risk of bleeding. If you’re on a daily baby aspirin for therapeutic reasons, you can continue as prescribed. If Tylenol is not suitable for you or if you experience more significant pain, please don’t hesitate to contact our office for further guidance to ensure your comfort during the recovery process.

Scarring is inevitable with skin cancer treatment, but Mohs surgery minimizes scarring by preserving healthy skin tissue. Scars often improve considerably within a year, and Dr. Feinstein will advise you on additional options for reducing the visibility of your scarring.

As the area where the surgery took place heals, new blood vessels may emerge, aiding the skin’s restoration beneath the skin. This process could lead to a temporary reddish tint in the appearance of the scar that improves over time. If any issues arise during the healing process, Dr. Feinstein may recommend injections, laser therapy, or other treatments to enhance the cosmetic outcome.

As with any surgery or procedure, Mohs is associated with possible risks and complications. While it is overall a very safe and effective surgical treatment for skin cancer, there are some possible complications, which include (but are not limited to) bleeding, bruising, wound infection, pain, scarring, and poor wound healing. Overall, most patients tolerate the Mohs surgery very well without any complications.

Mohs surgery is highly effective for certain types of skin cancer, especially basal cell carcinoma and squamous cell carcinoma. It is also utilized for some cases of melanoma. However, its application depends on factors such as the type, size, and location of the cancer. A consultation with our board-certified Mohs surgeon is crucial to determine the most appropriate treatment plan based on your individual circumstances.

If you choose not to undergo Mohs surgery, there are alternative options for treating skin cancer that your dermatologist can explore based on your specific circumstances. These alternatives may involve methods such as a surgical excision. It’s important to note that standard excision removes both the visible growth and some surrounding tissue, potentially leading to significant scarring and may not ensure complete eradication of cancerous cells. Dr. Feinstein will discuss these options with you and recommend the most suitable approach tailored to your individual case.

The cost of Mohs surgery is based on several factors. If you’re insured, your deductible, copays, and insurance plan details will influence the cost. If you’re uninsured, we can provide an estimated cost. Each Mohs procedure is unique, as the number of tissue layers to be removed and examined can’t be determined in advance. A consultation will allow your dermatologist to assess your skin cancer and create a tailored treatment plan. Additionally, the complexity of the repair needed for optimal post-surgery healing and appearance will impact the cost, based on the location and size of the resulting defect after cancer removal.

There’s no association between Mohs surgery and the spreading of any cancer. In fact, Mohs surgery provides the highest cure rates for many types of skin cancers.

Mohs surgery has a cure rate of 95% for all types of skin cancer and dramatically reduces the likelihood of recurrence. This specialized procedure involves the removal and examination of suspect tissues until only non-cancerous tissue remains. While it’s possible for skin cancer to recur after Mohs surgery, it’s unlikely, especially when performed by a top Mohs specialist. Basal cell carcinoma (BCC), the most common type of skin cancer, presents a low recurrence rate of about 5% over five years for previously untreated cases. However, patients who undergo Mohs micrographic surgery experience an even lower recurrence rate, of only 1%, showcasing an impressive 99% success rate in preventing BCC recurrence.

With the Mohs technique, Dr. Feinstein, board certified in Mohs surgery, will precisely identify, and remove the entire tumor while leaving the surrounding healthy tissue intact and unharmed. This technique involves removing the skin cancer in stages, one tissue layer at a time. It is performed under local anesthesia and in the comfort of our office. Once a tissue layer is removed, its edges are marked with colored dyes, and a map of the specimen is created. The tissue is then frozen and processed onto microscope slides by a Mohs histotechnician. These slides are carefully examined under the microscope by Dr. Feinstein so that any microscopic roots of the cancer can be precisely identified and mapped. If cancer cells are seen, an additional tissue layer is removed only in areas where the cancer is still present, leaving normal skin intact. This saves as much normal, healthy skin as possible.

After Mohs surgery, a follow-up visit to the office is necessary. If sutures were used, you’ll return within 7-14 days for their removal. For wounds not closed with sutures, a wound check is scheduled every 1 to 2 weeks. If you require assistance with bandage changing, we are happy to assist with coordinating wound care.

The duration of Mohs surgery varies based on factors like size, location, and type. On average, the procedure takes around 3 to 4 hours or longer if necessary. Here’s a breakdown of the process:

Step 1: Local anesthetic is administered to numb the area.

Step 2: A thin layer of tissue containing the tumor is removed.

Step 3: The tissue is then marked to identify the right, left, top and bottom to create a map of the tissue being processed.

Step 4: Dr Feinstein examines the entire bottom and outer edges of the removed tissue layer under a microscope.

Step 5: If there are any cancer cells seen in the sample, Dr. Feinstein identifies the precise location (according to the markings and the map) and an additional layer of tissue will then be removed. The process then continues until all margins are free of skin cancer cells.


Feel Good About Your Skin

At Feinstein Dermatology & Cosmetic Surgery, we understand that your skin is more than just an organ; it reflects your well-being and confidence. Our dedicated team of board-certified dermatologists and skincare specialists is committed to guiding you on a transformative journey toward feeling fantastic in your own skin. With a personalized approach to dermatological and cosmetic care, we aspire to be your trusted partners for a lifetime of radiant, healthy skin. Take the next step towards embracing your confidence with advanced skincare solutions, cosmetic treatments, or skin cancer treatment in Delray Beach, FL. Schedule a consultation for Mohs surgery today at (561) 498-4407.