Dr. Ariel Ostad is triple board certified in Dermatology, Mohs Micrographic Skin Cancer Surgery, and Facial Cosmetic Surgery. He’s also an Associate Clinical Professor at NYU, teaching residents how to perform flawless surgeries.


Mohs micrographic surgery is the most precise of the many skin cancer treatments available, with the highest cure rate and the least cosmetic damage. It is one of the most sophisticated and complex skin surgeries, requiring extensive training and a high skill level. Dr. Ostad is among New York’s top Mohs surgeons, known for exceptional results and artisan aesthetic outcomes. He was fellowship-trained at UCLA in Mohs micrographic surgery and facial reconstruction and has considerable experience with skin cancer diagnosis and treatment.

What Is Mohs Micrographic Surgery?

Mohs micrographic surgery is a procedure that is usually employed to treat skin cancer by cutting away the cancerous layers. It is mostly used for the most common types of skin cancer, including basal cell carcinoma and squamous cell carcinoma. With that said, it could also be used to treat the less common forms of skin cancer such as melanoma, albeit with the appropriate auxiliary treatment.

The surgery is often recommended for skin cancers that have a high risk of coming back (e.g., one that has already returned). If you want to keep as much of the healthy tissue as you can but the hardly defined tumor makes that difficult, the precision of Mohs micrographic surgery can keep the scarring at a minimum. The treatment is also recommended for those whose cancers are large and appear to be growing quickly

How Mohs Micrographic Surgery Works

Mohs micrographic surgery works by cutting the cancerous skin layer by layer through repeated surgical excisions. Each layer is then taken to the on-site lab, where Dr. Ostad will look for evidence of cancerous cells. Thin layers will continue being removed until no cancer cells are visible on the microscope cancers. 

Due to its meticulous approach, Mohs micrographic surgery has a 99 percent cure rate for certain types of cancer. Its purpose is to restore the health of the skin and body while preserving the aesthetic factor, minimizing the amount of healthy tissue taken out.

img

Common Treatment Areas

Since Mohs micrographic surgery is used for medical purposes and to remove skin cancer, it can be used on any skin area where skin cancers are present. That said, the procedure is mostly popular for areas where aesthetic preservation is important. This can include the following:

  • Face
  • Nose
  • Ears
  • Neck
  • Eyelids
  • Lips
  • Hands
  • Feet
  • Nipples/Areola
  • Genitalia

Personalized Treatment Plans

Customized Consultations

Regardless of the treatment area or type of skin cancer you want removed, Mohs micrographic surgery can effectively reduce unhealthy skin cells. Dr. Ostad can create a custom treatment process after the initial consultation, removing the entirety of the cancer as much as possible and restoring the health of your skin. This treatment is an effective way to maintain beautiful features with less scarring while removing the cancerous tissue entirely.

Treatment Process

The treatment process may vary for every patient, depending on the size of the cancerous formation. However, Dr. Ostad usually follows a series of key standard steps for an effective treatment. This can include the following:

Anesthesia: Dr. Ostad will numb the area containing the tumor, injecting it with local anesthesia. No general anesthesia is required to perform this procedure.

Visible Tumor Removal: The main “bulk” of the tumor will be gently scraped with a curette (a scoop-shaped instrument). This defines the edge between the healthy tissue and the tumor. The first “layer” is then removed and placed under the microscope, stopping potential bleeding with an electric needle. 

Tumor Mapping: The tissue is “mapped,” the mark corresponding with its location on the body. The tissue will also be color-coded when labeled to identify the position on the map.

Lab Examination: Dr. Ostad will process the tissue and take it to the on-site lab for examination. The section will be placed under the microscope, where it is determined if any cancer cells are left there.

Repeat Layer Removal: Should the lab results show the presence of cancer cells, Dr. Ostad will repeat the process and remove another layer to examine. This will continue until the microscopic analysis looks clear of cancer.

Reconstruction: After removing the cancer, Dr. Ostad will proceed to reconstruct the area, maximizing the aesthetic outcome. Stitches can be used where appropriate, but skin grafts or flaps can also be applied where significant tissue has been removed. 

The surgery can take a couple of hours. Bigger and deeper tumors often take a longer time to process and excise completely.

Benefits of Mohs Micrographic Surgery

High Cancer Cure Rate

Mohs micrographic surgery has one of the highest cure rates, going as high as 99 percent. This number is higher than any other skin surgery, making it an effective choice for when you have been diagnosed with skin cancer. The procedure can help reduce numerous types of skin cancer, from basal to squamous cell carcinoma.

Lower Regrowth Risk

Since Mohs micrographic surgery removes the unhealthy cells layer by layer until only the healthy ones remain, the chances of regrowth are minimal. You should not have to go through multiple treatments once the cancer has been cleared, but Dr. Ostad does recommend a yearly check-up for safe measures.

Minimal Potential for Scarring

Mohs micrographic surgery aims to maximize the preservation of healthy skin, only taking out the cancerous cells with great extraction precision. This means removing the cancer cells layer by layer until the last one appears clear of cancer, not taking any more skin than necessary. This minimizes the chances of scarring, especially if the carcinoma has not yet reached a large size.

Minimally Invasive

Most procedures aiming to reduce skin cancer will likely place you under general anesthesia to reduce discomfort. However, the precise action keeps the treatment contained, meaning only local anesthesia should be required. This should reduce the risks of complications associated with general anesthesia.

Reviews

Mohs Micrographic Surgery for Different Conditions

Beyond Cosmetic Uses

Mohs micrographic surgery is known for its ability to treat non-melanoma skin cancers, featuring the highest cure rate in comparison to other procedures. It is used against both slow and fast-growing cancer, where the cancerous tissue only covers a small area on the surface. That said, professionals are considering using Mohs for cosmetic reasons, adapting it to remove benign formations. 

For instance, Mohs micrographic surgery may be used to remove a benign mole that keeps reappearing after removal. Scar revision can also be addressed with Mohs, working on it layer by layer. While the use of Mohs beyond medical purposes is still in the early stages, the procedure can be adapted to fit different needs.

Success Stories

This patient had a Squamous Cell Carcinoma on his nose that we treated with Mohs micrographic Skin Cancer Surgery. Mohs Micrographic Skin Cancer Surgery is the most effective and conservative treatment option for skin cancer in difficult to treat areas such as the head and neck. It is performed under local anesthesia with reconstruction done immediately afterwards. This is an excellent treatment for preserving as much healthy tissue as possible for the most optimal scar appearance.
This patient had a Squamous Cell Carcinoma on his right wrist. He had this lesion treated twice without Mohs Surgery at a different physician’s office and it recurred. Mohs Micrographic Skin Cancer Surgery is the most effective and conservative treatment option for skin cancer in difficult to treat areas.
This patient had a Squamous Cell Carcinoma on his ear. We performed Mohs Micrographic Skin Cancer Surgery which is performed under local anesthesia with reconstruction done immediately afterwards. Skin cancer reconstruction requires meticulous suturing and awareness of facial anatomy and proper planning to bring the skin together without distorting other facial features. This will result in a well healed minimal scar which will be barely noticeable. In this example, a skin graft taken from behind the ear was used to cover the area on the front of the ear.
This patient had a Squamous Cell Carcinoma on his right wrist. He had this lesion treated twice without Mohs Surgery at a different physician’s office and it recurred. Mohs Micrographic Skin Cancer Surgery is the most effective and conservative treatment option for skin cancer in difficult to treat areas.

Frequently Asked Questions

What is Mohs micrographic surgery?

Mohs micrographic surgery is a surgical procedure that removes skin cancer. Thin skin layers are cut off surgically and processed by sectioning them horizontally. In case cancer is found in the tissue margins, it is mapped with another layer being taken. The process is repeated until the entire skin cancer is removed.

What areas are treated by Mohs micrographic surgery? What are the benefits?

This surgery is mainly performed on the face to treat skin cancer. It is also useful for treating cancer on the nose, lips, ears, and eyelids. Mohs micrographic surgery is beneficial for treating cancers that have recurred or have ill-defined borders. The benefits include a 99% cancer cure rate, minimized risk of regrowth, minimal scarring, and protection of healthy tissues.

How do you take care of the wound after surgery?

Dr. Ariel Ostad will provide verbal and written instructions on caring for the wound after surgery.

Where is the procedure performed?

Our facility is certified by the AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities), and the procedures are performed in our office. The treatment generally takes less than two hours, and our team will ensure your comfort.

Will I have a scar after receiving Mohs micrographic surgery?

As a Board Certified Mohs Surgeon with over 25 years of experience, Dr. Ostad has completed over 25,000 cases. He has studied advanced techniques for facial reconstruction, ensuring minimal scarring and excellent cancer removal outcomes.

How long does the procedure generally take?

The length of the procedure depends on the location and size of the tumor. Typically, it takes three to four hours if around two skin layers are removed. Preparing the skin for examination takes about an hour.

Will I have to be admitted after undergoing Mohs micrographic surgery?

Mohs micrographic surgery is an outpatient treatment. Patients can go home the same day, as only local anesthesia is used. You may have someone drive you home if you prefer, but it is not required.

Are the side effects of the procedure bad?

The side effects are minimal since Mohs surgery spares healthy tissue. Most patients experience some pain for the first few days, which can be managed with over-the-counter medicine. Common side effects include bleeding, redness, and swelling, which Dr. Ostad can help you manage effectively.

How long until I fully recover from Mohs micrographic surgery?

Recovery time depends on the extent of the procedure. Superficial wounds take one to two weeks to heal, while deeper wounds may take six weeks or more. Most patients return to work within 11 to 13 days after the procedure.

About. Dr. Ostad

Dr. Ariel Ostad is a board-certified dermatologist and dermatologic surgeon in New York City. With over two decades of experience, Dr. Ostad is renowned for his dermatology and skin health expertise, including Mohs micrographic surgery. He is a leader in his field, offering personalized and advanced treatment plans to help patients get rid of skin cancer. Dr. Ostad is dedicated to providing the highest standard of care, utilizing the latest techniques and technologies to ensure the best results.

Mohs micrographic surgery is available at Dr. Ostad’s office in NYC, where he provides top-quality care and treatment plans.

Have more questions?

You can contact our office if you have other questions that are not covered in this FAQ. We will offer all the details you need to make informed decisions about medical treatments.

Expert Answers

When is it recommended to go to the plastic surgeon for the reconstruction?

It is not recommended to go to a plastic surgeon. Dr. Ostad is board certified in Mohs Micrographic Surgery as well as Facial Cosmetic Surgery. He is able to perform Mohs Surgery as well as the Reconstruction in the same visit so there is no need to see a plastic surgeon.

How effective is Mohs Surgery in treating skin cancer?

Mohs Surgery has a cure rate of 99% (higher than any other skin surgery), a lower risk of regrowth than other treatments, minimal potential for scarring, and exact precision which will reduce the chance of leaving any cancerous cells, without removing healthy tissue.

Combining Mohs Micrographic Surgery with Other Treatments

Complementary Treatments

Mohs micrographic surgery usually works well on its own to offer superior results, but it can also be combined with other treatments for a better effect. When the skin cancer is particularly aggressive, Mohs micrographic surgery may be accompanied by radiation therapy to kill off the cancer cells. Depending on the circumstances, radiation can be used before the Mohs surgery to minimize the amount of tissue being removed.

Photodynamic therapy and certain types of laser treatments can also be used for superficial and pre-cancerous lesions, maximizing the effect. Dr. Ostad may choose complementary therapies once the extent of your cancer has been determined. Reconstructive procedures like scar revision surgery might also be used when a visible scar remains after the procedure.

Comprehensive Treatment

Mohs surgery might benefit from comprehensive treatment by following a more holistic approach. This includes not only the actual removal of the tumor but also supportive treatment to aid the healing. This is important considering that Mohs micrographic surgery is often used in cosmetically-sensitive areas.

Supportive treatments like medical-grade skincare can help improve skin healing outcomes, especially in sensitive areas. Dr. Ostad will evaluate your condition, integrating the appropriate treatments to offer the desired results.

Latest Trends and Innovations

Advanced Techniques.

Mohs micrographic surgery has seen plenty of recent advancements, improving the precision and effectiveness of the procedure. In the past, the procedure had a cure rate of 95 percent, but with today’s advanced techniques, it can go as high as 99 percent. 

Dr. Ostad uses advanced imaging technologies to visualize the tumor’s boundaries in real-time, improving extraction accuracy. Cancer cells are easier to identify as the layers are removed, reducing the number of times the samples are sent to the lab. The technology is particularly efficient when removing cancerous tissue from difficult-to-reach areas.

Innovative Uses

In the past, Mohs micrographic surgery has been used to treat conditions like basal or squamous cell carcinoma, which are more superficial. Lately, the procedure has begun being used for other types of skin cancer, melanoma included. While wider excisions are often used to prevent the recurrence of this type of skin cancer, Mohs micrographic surgery can be used to address the melanoma in its early stages.

Additionally, Mohs micrographic surgery can also address some skin cancers that go beyond the skin. Recent developments have shown the efficiency of using Mohs for treating soft tissue sarcoma, where the cancerous cells form in the connective tissue. Its potential is being researched to be used in other types of cancers as well, removing malignant tumors that have not yet metastasized in the body.

Safety and Expertise

Why Choose Dr. Ariel Ostad

As one of the nation’s most respected Mohs micrographic surgeons, Dr. Ostad has co-authored journal publications and medical textbooks on the subject. He is frequently requested to speak or lecture about the Mohs technique.

Dr. Ariel Ostad is triple board certified in Dermatology, Mohs Micrographic Skin Cancer Surgery, and Facial Cosmetic Surgery. His advanced skills and techniques have led to many honors, and he has been listed as a Top Doctor by Castle Connolly and RealSelf, and a New York Super Doctor. 

If you have been diagnosed with skin cancer or believe you may have a cancerous lesion, call (212) 517-7900 and schedule a consultation with Dr. Ostad to find out if Mohs surgery is right for you.

List of Credentials: 

  • Top-Rated Mohs Micrographic Surgery Provider
  • Trained at Harvard, UCLA, and NYU
  • Triple Board Certification in Mohs Surgery, Cosmetic Dermatology, and Facial Cosmetic Surgery
  • 3-Time Recipient of NYU Dermatologic Surgical Attending of the Year
  • Top Doctor, As Listed by Castle Connoly (2012-2024)
  • New York Super Doctor (2014-2024)
  • Clinical Associate Professor at NYU Department of Dermatology

Commitment to Safety

Dr. Ariel Ostad’s office has been designed to be comfortable, aesthetically pleasing, and safe for the patients. For this reason, we maintain strict sanitation, safety, and cleanliness standards so that you can rest assured whenever you come into the office. 

Dr. Ostad has invested in the highest-quality layers and advanced therapeutic devices to keep up with medical advancements. The equipment used for Mohs micrographic surgery is high-end, not only for the treatment area but also for the on-site lab. The office has received full certification from AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities), making it a top surgical facility.

Awards and Certifications

Educational Resources

Latest Blog Posts

Dr. Ariel Ostad has seen patients for this service, including BOTOX in NYC, from all over the tri-state area, including Manhattan, Midtown, the Upper East Side, the Upper West Side, Brooklyn, New York City, the Bronx, Harlem, Astoria, Queens, Long Island, New Jersey, Connecticut, and more. If you are interested in any of the services offered at the Office of Dr. Ariel Ostad, please contact us for more information.

BOTOX in NYC Doctor - Dr. Ariel Ostad

Medical-grade skincare products that will help maintain and enhance your results

These skincare products combined with your treatment plan customized by Dr. Ostad will help enhance your results and improve your overall skin texture. Click on a product below to learn more.

Dr. Ariel Ostad has seen patients for this service from all over the tri-state area, including Manhattan, Midtown, the Upper East Side, the Upper West Side, Brooklyn, New York City, the Bronx, Harlem, Astoria, Queens, Long Island, New Jersey, Connecticut, and more. If you are interested in any of the services offered at the Office of Dr. Ariel Ostad, please contact us for more information.

Schedule a

Consultation

  • This field is for validation purposes and should be left unchanged.

By submitting this form you agree to be contacted via phone/text/email.