Surgical Dermatology
Surgical Procedures
A highly skilled surgeon, Dr. Miller regularly performs the following procedures:
- Cyst Removal
- Lipoma Removal
- Mole Removal
- Skin Cancer Removal
- Moh’s Micrographic Surgery for Removal of Complicated Skin Cancer
Cysts
Two types of cystic growths occur frequently in human skin. Both represent a pouch-like growth from a hair follicle. The most common of the follicular cysts is the epidermal inclusion cyst, often referred to by the misnomer sebaceous cyst. This cyst most often occurs on the face, chest, and back and can vary in size from a few millimeters to many centimeters in diameter. Pilar cysts occur mainly on the scalp. People can have multiple pilar cysts as an inherited condition. Dr. Miller can remove even the largest cysts through an incision about 6 to 12 millimeters (1/4 to 1/2 inch) long, leaving a minimal scar.
Lipomas
Lipomas are benign tumors of fat cells that grow in the fatty, deepest layer of skin or under muscle fascia. They range from one to many centimeters in diameter and can occur multiply in an inherited condition called familial multiple lipomatosis. Although benign, these growths can cause discomfort and be a nuisance. Dr. Miller removes these lesions through a small incision, leaving a minimal scar.
Mole Removal
Moles are extremely common skin growths that can range from a few to hundreds in number. The vast majority of moles are benign, but they are often removed for cosmetic or functional reasons. Dr. Miller has removed thousands of moles using meticulous surgical techniques resulting in no visible scarring.
Skin Cancer Removal
Skin cancer surgery has been a focus of Dr. Miller since his earliest days as a dermatology resident. The majority of skin cancers are basal cell carcinomas and squamous cell carcinomas. Fortunately, they grow slowly and stay confined to the skin but can be quite extensive when a patient is present for treatment.
The less common, but more life-threatening skin cancer is melanoma, which has been increasing in incidence. However, with increased public awareness, dermatologists are detecting these cancers at earlier stages, when they can be cured surgically.
Dr. Miller has performed thousands of skin cancer surgeries spanning all areas of the body. Each surgical defect (the area of skin removed in order to cure the skin cancer) is repaired using advanced plastic surgical techniques engineered individually for location and skin type, achieving the best possible cosmetic results with little to no visible scarring.
Mohs Micrographic Surgery for Removal of Complicated Skin Cancer
Mohs micrographic surgery is a specialized, highly effective technique for the removal of skin cancer. The procedure was developed in the 1930s by Dr. Frederic Mohs at the University of Wisconsin and is now practiced throughout the world. Mohs surgery differs from other skin cancer treatments. This procedure permits the immediate and complete microscopic examination of the removed cancerous tissue, so that all “roots” and extensions of the cancer can be eliminated. Due to the methodical manner in which tissue is removed and examined, Mohs surgery has been recognized as the skin cancer treatment with the highest reported cure rate.
Some skin cancers can be deceptively large – far more extensive under the skin than they appear to be from the surface. These cancers may have “roots” in the skin, or along blood vessels, nerves, or cartilage. Skin cancers that have recurred following previous treatment may send out extensions deep under the scar tissue that has formed at the site. Mohs surgery is specially designed to remove these cancers by tracking and removing these cancerous “roots”. For this reason, prior to Mohs surgery it is impossible to predict precisely how much skin will have to be removed. The final surgical defect could be only slightly larger that the initial skin cancer, but occasionally the removal of the deep “roots” of a skin cancer results in a sizable defect. The patient should bear in mind, however, that Mohs surgery removes only the cancerous tissue, while the normal tissue is spared.
