Dr Ally-Khan Somani: Mohs Surgery Is a Gold Standard

Mohs surgery is generally the gold standard for rare and more aggressive tumors because the surgeon can ensure the roots of the tumor are gone, but the technique keeps the hole small, said Ally-Khan B. Somani, MD, PhD, at the 25th European Academy of Dermatology and Venereology Congress.

Do rarer tumors need to be operated on differently?
With Mohs surgery, because in a very simple way what we do is we go around the tumor—it doesn't matter what the tumor is. If it's a skin cancer, and there are different types, our goal is to check to see if we removed all the roots. So think of a tree. We're pulling out a tree and we're checking to see if the roots are there or not. Because if the roots are still there in the piece we've removed, then we need to line up those roots back to the patient and go back and dig some more. So it really doesn't change.

In fact, it is the gold standard for a lot of rare and more aggressive tumors because it affords us the ability to keep the hole small—which is good for the patient from a scar perspective—but also to provide them with a very high cure rate, which you would want if you're going to have a cancer on your face. You want to keep the whole small and you want to make sure it doesn't come back.

Are necessary cosmetic procedures covered by insurance, or do patients have to pay out of pocket?
Given the type of surgery I do, most of the surgeries I do are indicated, because patients are coming in with a cancer—in fact, that's pretty much my practice. However, if I do encounter a patient with a deviated septum or has a nasal issue, as long as there is a functional issue, then usually insurance companies will cover it. It's only when it's just a cosmetic, like rhinoplasty, that's not covered. It's considered a cosmetic procedure.
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