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Oct 3, 2003
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I've spoken to many in the field with their ear to the grindstone and evidently the new wave of derm in the next 5 years will be a "Derm procedures" fellowship (i.e MOHS combined with a couple of other months of lasers, cosmetics, etc.). Anyone have any further insight into this?
Also, the term "derm surgery" is pretty vague. I read that some dermatologists or derm surgeons can do "flaps" and other invasive procedures.
1. How common is this?
2. Do colleagues in the field frown upon this?
3. How do the plastics and ENT docs feel about this (assuming that the procedures are what I am perceiving them to be and might enfringe on some turf?)
4.How receptive are patients out there to having these procedures done by their dermatologist?

Appreciate any input and hopefully this will start a good thread.

ny skindoc

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Jul 30, 2002
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Most MOHS surgeons are very experienced in all sorts of closures including complex flaps.So called procedural fellowships have not caught on todate as funding for them has been sparse. Derm residents are exposed to Lasers and many of the common procedures you speak of and perform these routinely in their offices without a fellowship.ENTs and Plastic Surgeons dont really care about most dermatological procedures/excisions as they are interested in higher end cosmetic surgery-face lifts etc.Of course there are many turf battles in medicine and lots of people want a piece of the "cosmetic" pie.


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I am second year into my residency. So far, I have performed successfully many flap procedures on my own. I have performed Several O-to-Z flap, H flap, rhomboid flap, advancement flap, rotational flap, and A-to-T flap. I think dermatologist are very capable of performing the same flaps plastic surgeons do.

It is completely dependent on your training and comfort level.
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MOHS surgery was originally started by Dr. Mohs as a skin sparing technique for individuals who has skin CA (ie Basal cell, melanoma). This techique takes a tissue sample and analyzes it using frozen section and is repeated until a clear margin is achieved. Over the years, because Dermatologists have become more efficient using this technique, they have integrated it into the cosmetic side. Hope this helps.


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Originally posted by s4yxia
started by Dr. Mohs as a skin sparing technique for individuals who has skin CA (ie Basal cell, melanoma).

MOHS for melanoma is not a universally embraced technique. You're on much stronger ground with the SCC & BCC.
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