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Our Blog

A blog about cosmetic and reconstructive surgery of the face, including non-surgical procedures and skin cancer.

The Dangers of Precancerous Skin Lesions

Skin cancer can be devastating. News of tumorous skin cells growing amd multiplying at accelerated rates can be frightening. This is why prevention and early detection of skin cancer is key. Prior to the development of skin cancer cells and tumors, lesions may be seen on the surface of the skin.

Several types of precancerous lesions can exist on the outermost layer of the skin, a precursor to skin cancer if left untreated. Melanoma in situ, acitinic keratosis, atypical moles and atypical fibroxanthoma are examples of precancerous skin lesions.

We recommend prompt diagnosis and treatment by a skin cancer surgeon. Any dangerous lesions should be immediately surgically removed and excised.

Many removal methods exist depending on the size, type and location of the pre-cancerous lesion. A dangerous lesion, can evolve into various types of tumors- each with its own risks of rapidly spreading throughout the skin.

We recommend sun protection and limited sun exposure to all our patients to prevent precancerous lesions and growths like harmful moles from developing.

If you suspect you have a dangerous growth or lesion on your skin, do not wait. Schedule your examination today with Dr. Robert Schwarcz, a cosmetic, reconstructive and skin cancer surgeon.

Risks of Skin Cancer & Pre-Cancerous Lesions

Skin cancer is dangerous and presents real health issues for an individual diagnosed with one of the many forms of skin cancer or a pre-cancerous skin lesion that has not yet developed into cancer. Both must be treated and removed in a timely manner to eliminate any health risk. Many people can develop skin tumors from excessive sun exposure, lack of sun protection, and inadequate care of the skin. This is why such cancers must be detected and screened by a doctor.

Skin cancer can develop on the body as well as the face. When present on the face, the tumor can leave behind scars if left to grow very large. Various removal and surgery techniques exist to eliminate pre-cancerous lesions and skin cancer tumors. Mohs surgery is one surgical method of skin cancer treatment and removal which extracts each layer of tumors present in the skin. Curettage and electrodessication is another method used to treat basal cell and squamous cell cancers. This procedure can be performed by a general surgeon or dermatologist.

Dr. Schwarcz is a cosmetic plastic and reconstructive surgeon who routinely performs skin cancer surgery removal and treatments.

Eyelid Skin Cancer Surgery and Eyelid Reconstruction

Cancerous and benign skin lesions commonly develop on eyelid skin because the skin is thin, and it receives a substantial amount of long-term sunlight exposure. However, many eye-fold lesions are not cancerous. Dr. Robert Schwarcz, a board-certified oculoplastic cosmetic surgeon, can easily remove these lesions.

Common Eyelid Cancers

Squamous cell carcinoma and basal cell carcinoma are the two most common types of eyelid cancers. Basal cell cancer grows slowly, but it does not metastasize. Contrastingly, squamous cell cancer is more likely to spread. Any patient in New York City who has an ulcerated or bleeding lesion or nodule that will not heal should be examined and biopsied by a board-certified oculoplastic cosmetic surgeon. While rare, eye-fold melanoma calls for an aggressive treatment approach.

Basal Cell Tumors

Approximately 90 percent of tumors on the eyelid are basal cell tumors. Basal cell tumors may present as pearly nodules that eventually ulcerate. While basal cell tumors do not spread, they can grow into the surrounding tissue. An oculoplastic reconstructive surgeon can remove these tumors and reconstruct the affected area.

Squamous Cell Tumors and Melanoma

Squamous cell tumors are more aggressive than basal cell tumors, so they require a more complex skin cancer surgery technique than basal cell carcinomas to ensure the tumors have not spread. The surgeon will coordinate any further treatment with the patient. The severity and size of the tumor will dictate the next step in treatment.

Mohs Surgery for Eyelid Skin Cancer

A board-certified cosmetic surgeon has to meet three goals to achieve a successful eyelid skin cancer surgery outcome. The first goal is to remove all tumors. The second goal is to restore the eyelid’s functionality. Lastly, the third goal is to make the area look aesthetically pleasing. To reach these three goals, the surgeon will utilize the Mohs surgery technique. Mohs surgery is designed to carefully excise the cancerous tumor one skin layer at a time without removing a large amount of healthy tissue.

Depending on the complexity of the patient’s condition, the surgeon may need to either graft skin from another area of the patient’s body or simply suture the area. If the patient requires a skin graft, the treated area may need to be reconstructed in stages. Staged reconstruction is usually reserved for the most severe eyelid skin cancer cases.

What Everyone Should Know About The Moles On Their Bodies

Most people have at least a few brown spots on their skin. Most of these blemishes are totally benign. Some are freckles, some are moles and others may be skin tags or old age spots.

Moles usually are small lumps, slightly elevated above the level of the skin and darker in color than the skin. This is because they are composed of cells called melanocytes that produce the brown color in skin.

The danger of your moles

Some moles are not benign and can become cancerous. It is important to distinguish between simple moles and potentially dangerous lesions. Examining the moles on your body about once a month allows you to notice changes, especially if you take pictures of any questionable ones as a baseline.

The differences between moles and skin cancers, particularly melanoma, can help you decide when you need to see a skin specialist.


  • Moles are regular in shape and outline, generally circular or oval.
  • Cancers are irregular, spreading out in places.


  • The line that divides the mole from the normal skin is sharp, clear.
  • The border of a skin cancer is sometimes hard to identify as the lesion blends into the skin.


  • Moles are usually one color, often brown or tan.
  • Melanomas are multi-colored, with black, blue, red, brown and even white.


  • Most people have between 10 and 40 moles on their skin by the time they become adults.
  • A larger number of lesions is concerning.


  • Moles are smooth to the touch.
  • Skin cancers are often lumpy, and sometimes scaly, hard or rough.


  • Moles are small, rarely bigger than the diameter of a push pin.
  • Skin cancers are larger.


  • Moles stay the same or sometimes disappear as you age.
  • Skin cancers grow larger and the borders and shapes change.


  • Moles are usually on the face and upper body.
  • Melanomas are usually found on the chest and back in men and on the legs in women.

If any of your moles show these differences, or if they get itchy or bleed or hurt, you need to see a skin specialist for removal, such as Robert M. Schwarcz, M.D. in New York City and Scarsdale.

Contact him today to schedule a consultation.

How We Treat Melanoma Effectively With Mohs Surgery

Of all the human cancers, skin cancer is the most common cancer. It accounts for over three million people being diagnosed with basal cell or squamous cell carcinomas and in need of treatment annually, according to the American Cancer Society. Further statistics from ACS show that this year approximately 73,000 people will die from melanoma, the most aggressive form of the cancer. With skin cancer rates continuing to rise exponentially, it’s no wonder that the most effective surgical treatment would be the one most chosen. These days, that distinction belongs to the technique known as Mohs micrographic surgery. It wasn’t always so.

How does Mohs surgery treat skin cancer?

Dr. Frederic Mohs developed what became his eponymous method during the 1930s while a practicing general surgeon at the University of Wisconsin. Initially, he utilized a chemical composition containing zinc chloride to annihilate cancerous tissue by layers under precise microscopic control. Although Dr. Mohs’ continued experimentation favorably resulted in less chemical use and more microscopic analysis, Mohs surgery wasn’t considered viable for certain melanomas. Surgeons thought that some microscopic melanoma cells might be inadvertently missed with the technique and eventually metastasize.

Intensive research and refinements over recent decades have helped to facilitate the identification of melanoma cells. This advancement is due to special stains that were formulated to precisely highlight melanocytes, the actual pigment-producing cells.

Referred to as rapid counter MART-1immunostains, their composition permits a direct adhesion to melanocytes. Thus, the surgeon can quickly see the presence of melanoma under the microscope much more easily. Before the introduction of the MART-1 process, a hematoxylin and eosin compound stain was used. The H&E dye-crystalline combination couldn’t sufficiently produce accurate interpretations of frozen specimen sections. As a supplement to the historical stains, MART-1this drawback was nearly eliminated.

The benefits of this skin cancer treatment include:

Mohs surgery has now evolved into a valid option for treating certain melanomas. Its benefits are clear:

  • Affords meticulous mapping
  • Maximal preservation of healthy tissue
  • Eliminates estimation in gauging root depth
  • Achieves tumor-free margins
  • A cure rate of 99 percent for most skin cancers

Conduct Regular Mole Checks

Regular mole checks and removal is strongly recommended by physicians for both early skin cancer detection and prevention for all individuals. Some individuals are at a greater risk for developing skin cancer than others including individuals who have a family history that includes skin cancer as well as those with fair skin.

Screen yourself for precancerous moles:

All individuals who do have moles anywhere on their skin should keep an eye out for any changes in size, shape, color, or texture of the moles as these are possible signs of skin cancer. If any of these changes are detected by an individual at any time, he or she should schedule an appointment with a reputable physician as soon as possible so that a more thorough examination of the individual’s skin can be performed.

How mole removal is performed:

If a mole is deemed suspicious, a mole removal and biopsy will be performed. Mole removals should always be performed by a board-certified cosmetic surgeon because they have knowledge and experience in exactly what they are looking for as well as how deeply they can cut into the skin with minimal scarring.

Most mole removals can be done without the use of general anesthesia. Instead, the area of the mole removal will be numbed with a local anesthetic and the doctor will shave the mole off. If the procedure requires a doctor to go deeply into the skin, stitches will be required which may cause discomfort for the patient for a few days.

How Mohs Surgery Can Treat Skin Cancer Effectively

Dr. Fredric Mohs, from the University of Wisconsin, developed the Mohs surgical technique in 1938. For decades, it has been used successfully to save healthy tissue. Mohs surgery has the best cure rates and lowest recurrence rates when fighting skin cancer. Skin cancer is a growing problem that affects five million people each year in the United States. Early detection of skin cancer is a critical factor in preventing disfigurement and death from a variety of types of skin cancer.  Mohs micrographic surgery is the most effective form of skin cancer treatment and allows the patient to keep as much healthy skin around the tumor as possible.

What should I expect during this skin cancer treatment?

The Mohs micrographic surgery technique involves removing layers of skin, one layer at a time, to preserve as much healthy tissue as possible. This is done by examining the layers under a microscope during the procedure. In this way, the surgeon is able to determine where areas of abnormal cells end. The surgeon can preserve healthy tissue and limiting damage to the appearance of the skin. A reconstructive surgeon can then repair areas of the skin that show evidence of tissue removal to reduce scarring.

For many decades, Mohs micrographic surgery has been the preferred method for treating squamous cell carcinoma and basal cell carcinoma. Greater refinements in the technique have now made it possible for it to be used in melanoma, a more serious form of skin cancer. Patients who wish to maintain their appearance as much as possible, while still removing the abnormal cells of skin cancer, often appreciate preservative qualities of this technique.

The surgeon removes the cancerous tissue. He then maps the tissue and performs a microscopic exam on the edges of the tissue to determine that they are cancer free. The doctor can examine each layer of cells under a microscope. This is because some cancers that look small have actually penetrated deeply into the skin. When all the cancerous cells have been removed, the area of skin that was operated on is repaired and the surgery is over. Depending on the extent of the surgery needed, the doctor can use skin grafts, stitches or let the wound heal by itself. If any cancer remains on the edges, more tissue is removed from the precise spots shown by the mapping and microscopic exam. This process is repeated until there is no more cancer on the edges of the samples. The immediate microscopic exams allow the surgeon to be able to remove all of the cancer while leaving as much healthy tissue as possible.

Patients with squamous cell carcinoma have the highest cure rate with Mohs surgery. The cure rate with Mohs is as high as 99%. Patients with basal cell carcinoma will have the lowest rates of recurrence if Mohs is used. Mohs surgery is an excellent option for many patients fighting skin cancers of many types.

Most patients undergo Mohs surgery with local anesthesia which is applied prior to surgery. Mohs surgery is effective for patients who have cancer that grows very quickly and is especially effective for people who suffer from squamous cell skin cancer. This treatment is beneficial to patients who are at risk for their cancer returning or metastasizing to remote parts of the body. In addition, this treatment is utilized for skin cancer that appear on the face or other highly visible places which are particularly delicate. Mohs surgery is also performed when the cancer is large, has been treated but has returned or if the patient is a child. This technique allows patients to have a minimized surgical wound once the procedure has ended. A minimized wound will help patients to have minimized scarring.

When is Mohs micrographic surgery most appropriate?

Mohs surgery does take longer than other forms of treatment. It is, however, much more effective in many cases. The amounts of tissue removed are smaller. This leads to less scarring, faster healing, and fewer infections. It is also known that the cancer has been completely removed before surgery is finished and the wound is closed. This prevents recurrence and the need for repeated surgery.

Skin cancer is a serious matter. If you are fighting with skin cancer, talk to your dermatologist today. Mohs surgery offers the best chance for a complete cure with the smallest surgery possible.

Mohs surgery is appropriate for people who wish to get rid of squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs). Both of these forms of skin cancer are extremely prevalent. Mohs surgery is often chosen because it saves high amounts of skin tissue while simultaneously removing cancer cells.

Many people who have skin cancer choose to get Mohs micrographic surgery because of its strong recovery rates. Patients with BCC and SCC often have recovery rates of at least 98 percent with Mohs surgery. The cure rates are markedly stronger than those of other traditional excision techniques.

People who are interested in outpatient treatment plans should also consider Mohs micrographic surgery. When people receive these surgeries for skin cancer, they typically get local anesthesia. The ultimate objective of Mohs surgery is to get rid of skin that consists of cancer until all of it is 100 percent healthy and devoid of problematic cells.

The effectiveness of Mohs in treating skin cancer

Mohs surgery enables skin cancer surgeons to confirm that all of the hazardous cancer cells have indeed been successfully extracted during the procedure. The ability to have confirmation makes the chances of curing the cancer significantly stronger – a serious plus. At the same time, the confirmation also frequently stops patients from requiring any extra skin cancer surgeries or treatments. Individuals who want to get rid of skin cancer efficiently and smoothly might greatly appreciate Mohs micrographic surgery as a treatment option.

If you have skin cancer and think that this type of surgery might be a good choice for you, it’s your job to find a reliable and experienced cosmetic surgeon. Make sure you find a surgeon who has extensive experience in performing Mohs surgery procedures on skin cancer patients, as well.

Skin cancer is a very serious disease that can be lethal. Individuals with cancer have a number of treatment options they can employ to give them the best chance to beat the disease and continue with a long and healthy life. One of the more popular treatments for skin cancer is Mohs Surgery.

Where on the body can this procedure be performed?

Some believe that Mohs surgery is a procedure that can only be performed on the facial or neck area, this is untrue. This surgical procedure is not just limited to the facial area; it can also be used on the:

  • scalp
  • hands
  • genitals
  • feet
  • or even other places that have been affected by skin cancer

Consult with a cosmetic plastic surgeon

This type of procedure should only be performed by a surgical skin cancer professional. A highly trained and skilled reconstructive surgeon would be an excellent choice to perform this surgery. This procedure requires an individual that’s highly skilled and has been properly trained.

Choosing the right procedure and surgeon can help you to live a healthy and cancer-free life with limited scarring.

What to Do About Moles Found on Your Body

Not everyone has a mole as famous as some supermodels. In fact, most are unsightly, bothersome and potentially deadly. Whether you have skin tags that get irritated when they catch on clothes and jewelry, or an unsightly mole that shows signs of growth or changes in color or shape, having them examined and assessed is essential to not only your appearance, but more importantly your health.

Moles that turn cancerous

Most moles pose no health risk, however, some can result in malignant melanoma, which is the most dangerous form of skin cancer. If caught early through a mole check and a biopsy, the chances of it spreading are greatly reduced and it is virtually always curable. Regardless of your reason for mole removal surgery, once removed, your reconstructive surgeon will normally send a sample of the mole to a testing laboratory to confirm the cells are cancer free.

Anyone with a troublesome mole may be qualified for mole removal surgery. While removing a mole or skin tag is a simple procedure that can be accomplished in your cosmetic surgeon’s office with a local anesthesia, as with any surgery, there is some level of risk of associated scarring. Whether you are considering mole removal surgery on a mole having a negative effect on your appearance, or you are concerned about the possible health risks, your surgeon can evaluate your particular circumstances and discuss the possible risks and your individual options.

Alleviate your concerns about that mole or those skin tags by consulting with a board-certified cosmetic surgeon who can evaluate and typically remove them right away.

How To Protect Your Family and Yourself From The Sun

Summer is here, school is out, and you and your kids can expect to be spending lots of time in the sun this season. But, wait a minute – are they wearing sunscreen? Although skin cancer is quite rare in children, an excess of exposure to sunlight in childhood is the single most important risk factor in developing cancer later in life. This doesn’t mean, however, that you and your family must avoid the sun entirely this summer. By increasing your awareness of risk factors and symptoms, as well as methods of prevention, you can protect your children from cancer-causing sun exposure.

Be aware of the moles found on your skin

Melanoma is the deadliest form of skin cancer, and occurs rarely in childhood. However, some children are at greater risk for developing it in adulthood, due to a combination of hereditary factors and early sun exposure. Light skin and fair hair, as well as a family history of skin cancer, are two of these factors, along with having a great number of moles, or moles that are larger than average.

Moles are black or brownish spots consisting of pigment-producing cells. Most moles are harmless, but may develop into melanoma. For this reason, it is important to be aware of any moles and freckles your child may have, and check them for changes in size, color, and shape on a regular basis.

The key to preventing melanoma

Avoiding an excess of sun exposure, however, is the key to stopping melanoma before it starts. The American Academy of Dermatology suggests that the most effective way to avoid damaging UV rays is by shunning the sun between 10 am and 4 pm, when the rays are the strongest, and covering up in protective, tightly woven clothing. If you must spend an extended amount of time in the sun, choose a sunscreen with a Sun Protection Factor (SPF) of greater than 15, and UVA-blocking ingredients such as Parsol. Apply at least 30 minutes before being exposed to the sun, even on cloudy days, and reapply every two hours.

Seek the guidance of an experienced dermatologist

Along with taking protective measures against sun exposure, it is important to be examined yearly by a specialist, particularly if you or your child have a family history of skin cancer, or have noticed changes in a mole or birthmark. By preventing overexposure to sunlight, performing skin exams on yourself and your children, and consulting a physician on a regular basis, you can help protect your family from skin cancer.

Who is Qualified for Mohs Surgery?

Skin cancer is a prevalent disease in society today. This year alone, one million Americans will be treated for skin cancer; one in five people in the United States will develop skin cancer at some point in their lifetimes. Removing cancerous cells from the skin has, in the past, been a source of concern for patients worried about the scarring that can sometimes arise from surgery. Mohs micrographic surgery has been a popular choice for patients pursuing skin cancer removal.

Candidates for Skin Cancer Removal through Mohs Surgery

Candidates for Mohs surgery include individuals suffering from basil cell carcinoma and squamous cell carcinoma. Patients with melanoma have been discouraged in the past from pursuing Mohs surgery because of the concern that remaining cancerous cells may be missed so that the cancer can continue to spread. However, dyes have recently made it possible for melanoma to be removed through Mohs surgery.

Mohs Surgery: timing & goals

Mohs micrographic surgery is the process in which one thin layer of skin is removed at a time and studied for remaining cancer cells. If cancerous cells still exist, another layer is removed, and so on until the skin is cancer-free. This type of surgery has yielded fantastic results: 98% of patients were cured. This is due to the method of examining remaining skin cells for cancer during the surgery rather than after it is complete. Patients also benefit from very minimal scarring and an optimal cosmetic appearance following the procedure.

Mohs surgery should be performed following a diagnosis of skin cancer. All skin cancer patients have different needs, so discuss all of your options at length with your doctor and make sure you both agree that Mohs surgery is the best treatment option for you.

Mohs micrographic surgery can be performed by a cosmetic surgeon and is great option for anyone suffering from basil cell or squamous cell carcinomas. Talk to your doctor about what treatment is best for your needs.