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Skin Cancer Excisions

Palo Alto Dermatology Institute’s state-of-the-art facility in downtown Palo Alto is uniquely equipped in the San Francisco Bay Area to provide three different and highly effective “on demand” skin cancer excision techniques. On demand” means that the results of whether the tumor is completely removed occur in minutes instead of days or weeks.

We offer Mohs surgery, excision with face-frozen sections that provide the highest cure rates for all skin cancers, regardless of size, location, or subtype, and excision with traditional frozen sections.

Mohs surgery removes the cancer in staged, precisely mapped layers. Each stage is examined before additional tissue is removed, making it especially useful when maximum tissue preservation is critical, such as on the face, nose, eyelids, lips, and ears.

The immediate microscopic examination of the entire tissue specimen margin by frozen tissue processing techniques right in the office while you wait. Dr. Morganroth serves as the Mohs surgeon, the pathologist, and the reconstructive surgeon. In addition, our team of specially trained laboratory professionals prepares the tissue for immediate microscopic examination, allowing your surgeon to determine whether all of the cancer has been removed while you wait.

Mohs surgery is the gold standard for treating many basal cell carcinomas, squamous cell carcinomas, and selected melanomas located in cosmetically and functionally sensitive areas, where complete cancer removal and maximum preservation of healthy tissue are equally important.

Unlike standard surgical excision, in which only a small percentage of the surgical margins are examined under a microscope, Mohs surgery evaluates100% of the tumor margins during the procedure. This comprehensive margin assessment allows the surgeon to remove all cancerous tissue while preserving as much healthy skin as possible, resulting in the highest cure rates and the lowest risk of cancer recurrence.

Although both Mohs surgery and en face frozen section surgery evaluate essentially the entire surgical margin during the procedure, they differ in how the tissue is removed and processed.

Excision withen facefrozen sections provides the highest cure rates for all skin cancers, regardless of size, location, or subtype. En face frozen section excision is an advanced skin cancer removal technique that allows Dr. Morganroth to examine nearly 100% of the surgical margins immediately after the tumor is removed. Unlike traditional pathology, which evaluates only selected sections of tissue, the en face method examines the entire outer and deep edges of the specimen to ensure no cancer cells remain.

After the tumor is removed, the tissue is rapidly frozen and processed in our on-site laboratory. Dr. Morganroth then examines the margins under a microscope while you wait. If any cancer cells are detected, additional tissue is removed only where needed before the wound is repaired.

This technique offers cure rates comparable to Mohs surgery for appropriately selected skin cancers while allowing most patients to complete both cancer removal and reconstruction in a single visit. It is particularly valuable because it provides immediate confirmation that the cancer has been completely removed, reducing the need for a second procedure days or weeks later.

Instead of waiting 7 to 10 days for pathology results, your tissue is evaluated in our on-site laboratory while you wait. This allows your surgeon to confirm that the cancer has been completely removed before repairing the wound, minimizing uncertainty and significantly reducing the chance of needing additional surgery at a later date.

After the tumor is removed, the tissue is rapidly frozen, processed, and examined in our on-site laboratory while you wait. If the margins are clear, the wound is repaired the same day. If cancer cells remain, additional tissue can be removed immediately, greatly reducing the chance of needing a second procedure days or weeks later. The skin is not repaired until the margins are confirmed clear and the need for additional surgery one or two weeks later is virtually eliminated.

We tailor every treatment plan to provide the highest cure rate while preserving as much healthy skin as possible and achieving the best cosmetic outcome. The most appropriate treatment is determined by several factors, including the skin cancer’s histologic subtype (how the cancer cells appear under a microscope), its size and location, whether it is a new or recurrent tumor, your previous skin cancer treatments, and whether you have an inherited condition that increases the risk of recurrence or affects treatment outcomes.

At your consultation, we will have a discussion, listen to your concerns and preferences, and answer your questions, in order to recommend the best treatment for you.

Dr. Greg Morganroth is a nationally recognized Mohs and reconstructive surgeon with one of the largest and most experienced skin cancer surgery practices in the San Francisco Bay Area. His expertise in advanced skin cancer treatment and reconstruction allows patients to receive highly specialized care in one state-of-the-art facility. Schedule a consultation with Dr. Morganroth to learn about your diagnosis and all your treatment options.