At the Swier Clinic we treat a large number of patients with skin cancer. Skin cancers like basal cell carcinomas, squamous cell carcinomas and melanomas are removed usually in the office using local anesthesia and sometimes some sedation.
The surgical margins are checked under the microscope by Dr. Swier, as with Mohs micrographic surgery, immediately after resection of the lesion. We have a pathologist on the premises who helps with the preparing of the specimen and interpretation of the presence or absence of cancer cells.
Sometimes it takes 2 or 3 resections until all the margins are free of tumor. Following the resections the wound is reconstructed. Reconstructions include simple, intermediate or complex closures, local tissue rearrangements, local flaps or even skin grafts. Reconstructions are generally performed the same day that the cancer was removed.
The entire process generally takes 1–2 hours per lesion, but is a little unpredictable since reconstructions cannot be performed until all the margins are free of tumor. This is the reason that generally only one lesion is removed at a time. It is recommended that you take the day off work for the procedure, bring a good book to the office since minor delays are common and rest assured that Dr. Swier takes the times he needs to do an excellent job for everyone and will not be rushed.
Most procedures are done under local anesthesia, sometimes with some moderate sedation. If sedation has been used you are no longer legally allowed to drive and have to be accompanied by an escort to take you home.