Skin Cancer Treatment

Skin cancer removal through Mohs Surgery and other methods.

Skin Cancer Removal & the Innovative Mohs Surgery

As board certified dermatologic and skin cancer surgeons, OC Skin Institute is the expert facility in Orange County for skin cancer removal and Mohs Surgery.  As we plan the best treatment for each of our patients, we consider the size and location of the skin cancer, the patient’s age and medical history, and the potential for scarring. Your overall health is our skin cancer surgeons’ primary concern, and their goal is to completely eliminate the skin cancer with as little recovery and scarring as possible.

What is Mohs Surgery?

Mohs Surgery (named after its founder, Dr. Frederic Mohs), is an innovative micrographic technique for removing squamous cell and basal cell cancer. The cure rate using Mohs skin cancer surgery is very high, and recommended for large basal cell carcinomas on the body as well as for areas where recurrence of skin cancer is common such as on the scalp, face, hands, ears and nose. 

Some of the many advantages of Mohs surgery include:

  • Maximum preservation of healthy skin tissue
  • Minimal scarring
  • Its suitability for patients who have frequent skin cancers

Older patients in poor health as well as patients with diabetes and other immune system deficiencies can be treated safely, as well as those needing skin cancer removal around the delicate areas of the eyes and mouth.

The procedure for skin cancer removal by Mohs surgery involves a microscopically controlled excision of small sections of the tumor, then immediately examining it under a microscope. If we identify cancer, we’ll remove more tissue until the section of skin cancer is clear and only normal skin is visible. The “hole” left by the basal cell cancer is then repaired the same or next day, leaving only a thin scar.

Other successful methods for skin cancer and precancerous treatment at OC Skin Institute include:

  • Cryosurgery: Typically, we apply liquid nitrogen to abnormal growths to freeze and kill the precancerous cells. This is best suited for precancerous lesions called actinic keratosis in order to prevent them from becoming full blown skin cancers.
  • Curettage and Desiccation: Best suited for small skin cancers on the trunk, arms or legs, this method involves the skin cancer surgeon using a spoon-like instrument called a curette to remove the abnormal cells. The surgeon then applies an electrical current to kill the remaining cancer cells and control bleeding. The tissue heals without the need for stitches.
  • Prescription Creams: Applied topically for several weeks, these formulations attack basal cells and stimulate the immune system. Although this method avoids surgery and can be applied by the patients themselves, it usually produces skin irritation and inflammation and discomfort. This method is reserved for patients who cannot undergo surgery or when a cancer or pre-cancer is observed to be very superficial and not invading deeper skin.
  • Radiation Therapy: For areas that are difficult to treat with skin cancer surgery, or in patients who cannot undergo surgery due to other health conditions, OC Skin Institute may refer a patient for radiation treatments for squamous or basal cell cancers.
  • Surgical Removal: The skin cancer surgeon carefully removes the abnormal cells and stitches the area closed without immediate microscopic examination (as in Mohs skin cancer surgery). The specimen is sent to a lab to ensure that all of the margins are clear of skin cancer cells. This method is used for skin cancers on the body that are small and do not require Mohs Surgery.

At OC Skin Institute, we value our relationships with our patients and provide tailored expertise to each individual situation.  We have three locations throughout Orange County, including Santa Ana and San Clemente, suited to provide full skin cancer treatment services for all patients. Please contact us for a consultation and qualified analysis of your skin cancer treatment needs.

Before & After Gallery

Real patients. Real results.

  • Case Study #1

    Treatment: This is a case of a 42 year old gentleman with a large infiltrative basal cell carcinoma on the upper cutaneous lip extending onto the lip margin. Mohs surgery was complete in 2 stages followed by a lip wedge excision resulting in a thin linear scar.

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  • Case Study #2

    Treatment: This is a case of 40 year women with a basal cell carcinoma present in the nasal crease. Mohs surgery was complete in 1 level followed by reconstruction along the nasal labial fold. In this case, care was taken to orient the scar in the direction of the “smile line”.

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  • Case Study #3

    Treatment: This is a case of a 73 year old gentleman with a large infiltrative basal cell carcinoma on the ear. Mohs surgery was completed in 4 levels, followed by a full thickness skin graft.

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  • Case Study #4

    Treatment: This is a case of a 68 year old female with basal cell carcinoma on the nose. Mohs surgery was completed in 2 stages followed by a bilobed flap for reconstruction.

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  • Case Study #5

    Treatment: This is a case of a 70 year old gentleman with a squamous cell carcinoma on the left ear. Mohs surgery was performed and completed in 2 stages followed by an H-plasty helical rim repair.

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  • Case Study #6

    Treatment: This is a case of a 65 year old female with a large infiltrative basal cell carcinoma on the temple. Mohs surgery was completed in 4 levels followed by a rhombic flap for reconstruction. The final outcome resulted in a barely visible scar.

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  • Case Study #7

    Treatment: This is a case of 38 year old young women with a large, infiltrative basal cell carcinoma on the right cheek extending medially onto the nasal sidewall and ala. Mohs surgery was completed in 5 stages followed by an island pedicle flap. Care was taken to hide the scar within the adjacent “smile line”

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  • Case Study #8

    Treatment: This is a case of a small alar basal cell carcinoma on a young female patient concerned with the cosmetic outcome. A single stage of Mohs cleared the lesion followed by a small single advancement flap. Care was taken to avoid alar and nasal tip distortion.

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  • Case Study #9

    Treatment: This is a basal cell carcinoma defect after 6 levels of Mohs surgery. The defect was repair with a full thickness skin graft.

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  • Case Study #10

    Treatment: This is a basal cell carcinoma on the ear treated with 1 level of Mohs surgery followed by a full thickness skin graft.

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  • Case Study #11

    Treatment: This is a case of a 75 year old gentleman with basal cell carcinoma on the posterior ear treated with Mohs surgery in 2 levels and repaired using a rhombic flap.

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  • Case Study #12

    Treatment: This is a case of a 72 year old female with an infiltrative basal cell carcinoma present on the left post auricular region. Mohs surgery was employed and the tumor was cleared in 4 levels, followed by a large single advancement flap for reconstruction.

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  • Case Study #13

    Treatment: This is a case of basal cell carcinoma present on the right temple. Mohs surgery was employed followed by an O-T repair for reconstruction.

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  • Case Study #14

    Treatment: This is a case of a young gentleman with recurrent infiltrative basal cell carcinoma previous treated with Mohs surgery at another office. The patient underwent Mohs surgery with Dr. Nakhla and was cleared in 5 stages. The large defect was repaired using a single advancement flap carefully planned with all incisions placed along natural skin creases resulting in a nearly scarless surgery.

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  • Case Study #15

    Treatment: This is a case of a gentleman with a large basal cell carcinoma on the right neck requiring 4 levels of Mohs surgery followed by a large single advancement flap. Care was taken to place the incisions with a wrinkle on the neck resulting in minimally visible scarring.

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  • Case Study #16

    Treatment: This is a case of a young female patient with a large basal cell cancer on the nose. Mohs surgery was used to remove the tumor in 3 levels, followed by reconstruction using a hatchet flap resulting in an excellent cosmetic outcome considering the size and location of the tumor.

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  • Case Study #17

    Treatment: This is another case of a large tumor on the nose. This lesion was a squamous cell carcinoma of the keratoacanthoma type. Mohs surgery was employed followed by reconstruction using a tri-lobed flap from borrowed skin on the opposing side of the nose.

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  • Case Study #18

    Treatment: This is a basal cell carcinoma present on the nasal tip of a 83 year old female after 3 levels of Mohs surgery followed by a full thickness skin graft.

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  • Case Study #19

    Treatment: This is a case of a squamous cell carcinoma present on the dorsal surface of the hand after 1 level of Mohs surgery and a single advancement flap for repair.

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  • Case Study #20

    Treatment: Mohs surgery

    Patient Details:This is a case of basal cell carcinoma following mohs surgery and a full thickness skin graft on the helical rim of the ear.

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  • Case Study #21

    Treatment: Basal cell carcinoma on the left temple of a 78 year old gentleman after 4 levels of Mohs micrographic surgery. The defect was allowed to contract and granulate for 2 weeks followed by repair using a full thickness skin graft.

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  • Case Study #22

    Treatment: Basal cell carcinoma on the left temple treated with 3 levels of Mohs micrographic surgery followed by repair using an O-L single advancement flap.

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  • Case Study #23

    Treatment: This is a case of basal cell carcinoma treated with Mohs micrographic surgery followed by reconstruction using an O-T bilateral advancement flap.

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  • Case Study #24

    Treatment: Squamous cell carcinoma on the nose after 1 stage of Mohs micrographic surgery followed by linear closure.

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  • Case Study #25

    Treatment: This is a case of infiltrative basal cell carcinoma on a young female patient’s nose. The tumor extended all the way to the cartilage after treatment with 5 levels of Mohs micrographic surgery followed by a full thickness skin graft.

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  • Case Study #26

    Treatment: This is a case of infiltrative basal cell carcinoma on the right infraorbital region after 5 levels of Mohs micrographic surgery. The defect was repaired used a large single advancement flap from the zygomatic area.

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  • Case Study #27

    Treatment: This is a case of basal cell carcinoma on the scalp of a young man after 2 levels of Mohs surgery followed by linear closure.

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  • Case Study #28

    Treatment: Squamous cell carcinoma on the nasal tip after Mohs surgery followed by a hatchet flap.

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  • Case Study #29

    Treatment: This is a case of sclerosing basal cell carcinoma present on the upper cutaneous lip after 3 levels of Mohs micrographic surgery. The defect was extended laterally onto the nasal labial fold (smile line) to hide the scar within the natural fold.

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  • Case Study #30

    Treatment: Squamous cell carcinoma on the ear repaired with a bilateral H-plasty helical rim flap.

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  • Case Study #31

    Treatment: Melanoma Excisional Biopsy

    Patient Details:This is a patient that presented to OC Skin Institute with a large tumor on the back. The clinical appearance of the lesion warranted an excisional biopsy of the entire lesion with 1cm margins which was diagnosed as invasive melanoma.

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  • Case Study #32

    Treatment: This is a case of basal cell carcinoma on the scalp after 5 levels of Mohs surgery. The defect was closed with an O-T advancement flap.

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  • Case Study #33

    Treatment: Basal cell carcinoma treated with Mohs surgery and repaired with a linear closure on the cheek of a 72 year old woman.

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  • Case Study #34

    Treatment: Basal cell carcinoma on the left cheek treated with Mohs micrographic surgery and repair with a melolabial rotational flap.

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  • Case Study #35

    Treatment: Basal cell carcinoma on the nasal tip repaired using a rhombic flap

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  • Case Study #36

    Treatment: Basal cell carcinoma on the ear after 7 levels of Mohs surgery followed by a full thickness skin graft.

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  • Case Study #37

    Treatment: Squamous cell carcinoma on the brow of an 80 year old gentleman followed by repair using a single advancement flap

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  • Case Study #38

    Treatment: Lentigomaligna melanoma treated using Mohs surgery followed by repair with a large advancement flap.

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  • Case Study #39

    Treatment: Basal cell carcinoma on the nasal-cheek margin removed using Mohs micrographic surgery in two levels followed by linear closure.

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  • Case Study #40

    Treatment: Infiltrative basal cell carcinoma on the scalp cleared in 1 level of Mohs surgery followed by closure using a single advancement flap.

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  • Case Study #41

    Treatment: Squamous cell carcinoma present on the zygomatic cheek cleared with Mohs surgery in 2 stages followed by repair using a singe advancement flap.

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  • Case Study #42

    Treatment: Infiltrative basal cell carcinoma on the nasal labial region removed using Mohs micrographic surgery. The defect was closed in a linear fashion along the natural smile line crease.

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  • Case Study #43

    Treatment: Squamous cell carcinoma within the nasal labial fold treated with Mohs surgery and repaired in a linear fashion along the smile line crease.

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  • Case Study #44

    Treatment: Squamous cell carcinoma over the boney prominence of the patella (knee) treated with Mohs surgery and repaired in a linear fashion.

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  • Case Study #45

    Treatment: Squamous cell carcinoma on the right cheek treated with Mohs surgery and repaired in a linear fashion along natural skin creases.

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  • Case Study #46

    Treatment: Basal cell carcinoma on the earlobe removed with Mohs surgery in 3 stages followed by closure with an advancement flap.

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  • Case Study #47

    Treatment: Squamous cell carcinoma on the cutaneous upper lip removed with Mohs surgery and repaired using an advancement flap.

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  • Case Study #48

    Treatment: Basal cell carcinoma teated with Mohs surgery on the forehead followed by linear closure. Care was taken to place the incision within a natural forehead wrinkle.

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  • Case Study #49

    Treatment: Excision of lentigo maligna

    Patient Details:Lentigo Maligna present on the temple excised and repaired with a full thickness skin graft.

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  • Case Study #50

    Treatment: Squamous cell carcinoma present over a boney prominence on the wrist treated with Mohs surgery and repaired with a single advancement skin flap.

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  • Case Study #51

    Treatment: Squamous cell carcinoma on the scalp removed with 2 stages of Mohs surgery followed by repair using a single advancement flap.

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  • Case Study #52

    Treatment: Squamous cell carcinoma removed with 1 stage of Mohs surgery followed by full thickness wedge excision of the ear and primary closure.

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  • Case Study #53

    Treatment: Basal Cell Carcinoma removed with 2 stages of Mohs surgery. The repair was completed with an advancement flap, carefully placing the incision along normal anatomical lines within the lower eyelid folds.

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  • Case Study #54

    Treatment: Basal cell carcinoma on the scalp removed with 1 stage of Mohs surgery and closed using a single advancement flap.

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  • Case Study #55

    Treatment: Basal cell carcinoma on the scalp removed with 3 stages of Mohs surgery and closed using a single advancement flap.

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  • Case Study #56

    Treatment: Basal cell carcinoma on the nasal tip removed with 2 stages of Mohs surgery and repaired with a modified hatchet flap.

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  • Case Study #57

    Treatment: Infiltrative basal cell carcinoma on the right cheek excised in 1 stage of Mohs surgery and repaired with a single advancement flap.

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  • Case Study #58

    Treatment: Lentigo Maligna Melanoma

    Patient Details:Excised using slow Mohs technique and repaired with a full thickness skin graft.

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  • Case Study #59

    Treatment: Basal cell carcinoma on the right cheek excised with Mohs surgery in 2 stages, followed by linear closure.

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  • Case Study #60

    Treatment: Squamous cell carcinoma on the scalp excised in 1 stage of Mohs surgery followed by primary linear closure.

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  • Case Study #61

    Treatment: Basal cell carcinoma on the right posterior ear excised in 3 stages of Mohs surgery followed by repair using a full thickness skin graft.

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  • Case Study #62

    Treatment: Squamous cell carcinoma on the left cheek removed with Mohs micrographic surgery in 2 stages followed by a single advancement flap.

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  • Case Study #63

    Treatment: Basal Cell carcinoma on the nose removed with Mohs micrographic surgery followed by primary closure.

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  • Case Study #64

    Treatment: Basal cell carcinoma on the nasal ala of a young women removed with Mohs surgery in 1 stage followed by a single advancement flap.

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  • Case Study #65

    Treatment: Basal cell carcinoma on the nasal ala of a young women removed with Mohs surgery in 1 stage followed by a single advancement flap.

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  • Case Study #66

    Treatment: Infiltrative basal cell carcinoma on the posterior neck removed with Mohs surgery in 1 stage followed by primary closure.

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  • Case Study #67

    Treatment: Sqamous cell carcinoma on the left posterior ear removed with Mohs surgery in 1 stage followed by repair using a single advancement flap.

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  • Case Study #68

    Treatment: Squamous cell carcinoma on the left cheek removed with Mohs surgery in 1 stage followed by primary closure.

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  • Case Study #69

    Treatment: Infilrative basal cell carcinoma on the left preauricalar area treated with Mohs surgery in 2 stages followed by primary closure.

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  • Case Study #70

    Treatment: Basal cell carcinoma on the upper cutaneous lip removed with Mohs surgery in 1 stage followed by single advancement flap.

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