Mohs Surgery in Sarasota

Mohs surgery is considered the gold standard for treating skin cancer, where layers of skin are removed one at a time, then evaluated under a microscope until the cancer is completely gone.

Greco Dermatology is very well versed in Mohs surgery in Sarasota.

What is Mohs Micrographic Surgery?

Earning the name from its pioneer, Dr. Frederic Mohs, the Mohs microscopic surgery procedure involves surgically removing the skin cancer we can clinically see but then microscopically examining it to ensure no residual tumor remains.

That process repeats itself until the skin cancer is removed. Because of how we process it, we can evaluate 100% of the surface and leave the slightest possible defect, leading to the smallest possible scarring. Mohs surgery spares as much healthy tissue as possible & yields success rates up to 99%, the highest potential for most skin cancers.

Who is Mohs Surgery For?

Candidates for Mohs surgery in Sarasota are individuals who have skin cancer in cosmetically sensitive areas or functionally critical areas (around the eyes, nose, mouth, ears, or the head and neck in general).

Patients can expect to see results immediately from the removal of the skin cancer, and within 1-2 weeks of healing time. The best part of the Mohs procedure is that it offers the highest cure rate, with minimal downtime, and the smallest possible scar — which is most often imperceptible.

The Mohs Procedure at Greco Dermatology

Forming a Partnership

The consequences of sun damage are not always skin deep. Frustration, anxiety, and fear can accompany many dermatologic diagnoses — most notably, skin cancer. This impacts many aspects of daily life, and we understand that.

Our approach addresses the external, internal, and environmental struggles that all play a part in the process.This is why Joseph F. Greco, M.D. and his team at Greco Dermatology are with you every step of the way, from the moment you contact us to your very last follow-up. You can be confident that fellowship-trained Mohs surgeon Dr. Greco will detect the issue and expertly perform your surgery. You won’t need to go anywhere else. We want you to feel that you’ve formed a partnership with us.

“I wanted to specialize specifically in Mohs surgery because the nature of the procedure. The patient can remain comfortably in the room for the entirety of the procedure while I can serve in all phases of it: the skin cancer surgeon to remove the skin cancer; their dermatopathologist to make sure those margins are clear; and the reconstructive surgeon to repair the area. All of these phases are done in that same day. The patient can go home that day, free of the cancer, with the wound closed and a long-term plan in place. Personally, I love getting to know the patients and developing long-term relationships with them. Skin cancer patients are followed regularly and may have numerous lesions that develop the require attention over the course of many years. This ongoing relationship allows us to develop an extended family of patients, as we spend a good amount of time together.”

Fellowship-trained Mohs surgeon, Dr. Joseph Greco

Finding the Right Surgeon for Your Mohs Micrographic Surgery

When you’re diagnosed with skin cancer, it can be scary and overwhelming. We understand that you want a trusted and experienced doctor who has devoted their career to focus on the field of skin cancer treatment and reconstruction. You want an expert with unparalleled surgical experience. And finally, you want a physician who will listen to you and deliver extra effort in their care. This is Dr. Joseph F. Greco, a top Mohs surgeon in Sarasota and beyond.

Mohs Surgery: The Most Effective Treatment for Skin Cancer

Why is Dr. Joseph Greco a Top Mohs Surgeon?

15-year history as a Mohs surgeon at UCLA, one of the premier hospital systems in the nation; also served as Director of UCLA Santa Monica Dermatology and Dermatologic Surgery for 12 years
Double board-certified by The American Board of Dermatology in Dermatology and Micrographic Dermatologic Surgery
Fellowship-trained Mohs surgeon (micrographic), reconstructive surgery, cutaneous oncology, and laser surgery at The David Geffen School of Medicine at UCLA with an intense focus on microsurgical reconstructive techniques and utilizing advanced reconstructive and suturing techniques
Served as Health Sciences Associate Clinical Professor, Division of Dermatology, Department of Medicine at The David Geffen School of Medicine at UCLA
A member of The American College of Mohs Surgery: the premier organization of fellowship-trained skin cancer and reconstructive surgeons specializing in Mohs surgery in Sarasota

One of the first dermatologic surgeons to pass The American Board of Dermatology subspecialty exam to be certified in Micrographic Dermatologic Surgery 2021
One of a select number of double board-certified and fellowship-trained Mohs micrographic surgeons in the country
Appeared as a faculty presenter at numerous national conferences and workshops on surgical anatomy, advanced surgical reconstructive techniques, cutaneous oncology, and new laser and light source technologies
Author of an extensive list of book chapters, publications, and national lectures in the field of surgical anatomy, Mohs micrographic surgery, reconstructive surgery, cutaneous oncology, laser surgery, and the surgical anatomy of the head and neck
A 15-year history of skin cancer focus, which has allowed him to perform over 20,000 Mohs and surgical excision procedures
Participated in the training 14 Mohs micrographic surgery fellows
Recognized annually by peers as a SuperDoctor® in Southern California (2016-2022) as well as a TopDoctor® in Los Angeles in 2018

The Patient Experience at Greco Dermatology: A Personal Touch

At Greco Dermatology, we take great pride in our work, the professional relationship we develop with patients, and the overall experience during a visit to our office. Our goal is to provide a comfortable and soothing environment to help ease the anxiety surrounding skin cancer procedures. Your visit will be centered around an exceptional experience, as we treat you with respect, compassion, and individualized care.

Being the third generation to practice medicine in his family, Dr. Greco provides the quality of care for his patients that he learned from watching his grandfather and father practice. He and all of us here at Greco Dermatology offer warm, caring, friendly, and fun personalities in our bedside manner. Dr. Greco keeps appointments as lighthearted as possible, knowing that this helps bring his patients’ guard down if they are nervous. He treats each patient like they are someone from his own hometown.

We strive to offer the most comfortable and soothing environment possible. This includes providing a visually attractive office, spacious and newly designed patient rooms, soothing and engaging music during procedures, flat-screen TVs, and window space with beautiful views of Sarasota. When you choose to work with us, you’ll get more than just great dermatologic care. We provide an experience with an intangible aspect that makes our patients look forward to their next visit.

What to Expect During Your Mohs Surgery Consultation

Before your Mohs micrographic surgery, you will meet with fellowship-trained Mohs surgeon Dr. Greco to discuss your treatment and to establish a trusted and confident relationship, which is very important. During this first meeting, Dr. Greco will ensure that you have a comprehensive understanding of your skin cancer diagnosis.

He will also go over your treatment options, including risks, benefits, and alternatives. He will explain in detail the Mohs micrographic surgery procedure, appropriate indications for the surgery, and reconstruction options once the skin cancer is removed. He will also go over available techniques to help achieve imperceptible scarring.

Together with you, he will review all preparations needed for Mohs surgery, post-operative instructions, and potential post-surgical issues. He will talk to you about short- and long-term management plans to minimize the risks of future skin cancers and SkinIQ through skin cancer education strategies.

Preparing for Mohs Surgery

Continue your regular medications as prescribed. If taking any blood thinners such as Plavix® or Coumadin® (warfarin), consult with your prescribing physician. We normally do not stop them for surgery.
If you’re taking aspirin, NSAIDS, fish oil, vitamin E, gingko biloba, garlic, or other herbal supplements, please stop them 10 days prior to Mohs surgery unless another physician has advised otherwise.
Please tell us if you have a pacemaker, defibrillator, or other implanted device. Also let us know if you have an artificial joint or heart valve, have ever had rheumatic fever or a heart murmur, and/or if you take prophylactic antibiotics prior to surgery or dental cleaning.
For Mohs micrographic surgery, expect to stay with us for 2-4 hours. We offer music and flat-screen TVs for streaming as you wait, and you can also bring reading material, your iPad, snacks, etc. You’re welcome to bring a supportive family member or friend, but please keep in mind that space in the room is limited and the person you bring will have to remain in the waiting room during the active portions of the procedure.
Shower before your appointment, but please don’t use cosmetics, lotion, makeup, or perfume.
Wear something comfortable, particularly around the area where the skin cancer is. We will need access to this area. We recommend dressing in layers, as some rooms may be cold.
Unless the area being treated is near the eye, you should be able to drive home after the procedure. However, it’s always a good idea to have someone on standby to pick you up in case you don’t feel well enough to drive home.
If we see you as a consult prior to the day of surgery, make sure to fill any prescriptions and obtain supplies well ahead of time in order to reduce stress the day of surgery.
Get a good night’s rest and eat a hearty breakfast, making sure to take your medications as usual.
Please arrive 10-15 minutes early.

The Mohs Micrographic Surgery Procedure

The Mohs procedure can range from as fast as 45 minutes up to 3-4 hours. Top Mohs surgeon Dr. Joseph Greco will function in all phases of the Mohs surgery procedure and serve as the cancer surgeon, dermatopathologist, and reconstructive surgeon on the same day.

The area to be treated will be cleansed and local anesthesia via injections will be administered to help with any discomfort. Dr. Greco will use a scalpel to expertly remove the visible tumor with precision, along with a thin layer of surrounding tissue.

This tissue will be taken to our lab and placed onto slides so that it can be assessed under a microscope.

If Dr. Greco finds evidence of cancer in this tissue, he will return to you, remove another layer of tissue, and examine it under the microscope as well. Layer after layer of tissue will be examined until no more cancer is detected within the tissue.

This process ensures that only cancerous tissue is removed, which preserves as much healthy tissue as possible.

After Mohs Surgery: The Possibility of Mohs Reconstruction

Once the cancer is completely removed, Dr. Greco will immediately discuss the next steps to address the surgical wound with you.

Small, superficial wounds may be allowed to heal on their own. Some may be closed in a simple side-to-side manner, while others may require a skin graft or skin flap in order to preserve functional capabilities and maximize aesthetic outcome. If reconstruction and closure is needed, our goal is to do so on the same day, immediately after the skin cancer is clear.

Our goal at Greco Dermatology is to achieve near imperceptible scarring, and our attention to detail keeps scars as minimal as possible doesn’t stop once the surgery is complete. We will monitor you for several months as your skin heals, and we have many options if any “finishing touches” are requested or required. These may include dermabrasion, resurfacing, laser technology, bio-enhanced scar therapy with growth factors, scar micropigmentation, and cosmetic tattooing.

Recovery and Home Care

Downtime can be as fast as 1-2 days if we’re not closing the wound — that is, if Dr. Greco has decided to allow it to heal on its own. It may also take as long as 5-7 days if there are sutures on the face, or up to 10 days for sutures off the face. As with any surgery, there may be significant bruising and swelling the first week or two.

Other risks that are more rare include bleeding, infection, and mild to moderate pain and/or a “tight” sensation in the treatment area. Areas of the scalp, forehead, eyes, and nose may cause noticeable eyelid swelling, which is normal and expected. That said, we encourage you to plan your social calendar accordingly.

We recommend avoiding exercise, straining, and swimming for the first week or two. Any exertion — even bending down quickly — can cause bleeding of a head wound, as this area is so well vascularized. Prepare to take it easy. Catch up on some TV, use your computer, or read a book! Complete healing of the scar is typically finalized at 3-12 months.

Mohs Wound Care Instructions

The Importance of Being a Fellowship-Trained Mohs Surgeon

When you choose to work with Greco Dermatology, you can feel confident and assured you’re in the excellent hands of a fellowship-trained Mohs surgeon.

In addition to being a fellowship-trained Mohs surgeon himself, Joseph F. Greco, M.D. also trained other fellows at UCLA in Mohs surgery. A fellowship-trained Mohs surgeon must undergo:

A competitive application, review, and selection process to be chosen for training
Extensive, hands-on direction and education from highly qualified trainers who are themselves skilled practitioners of the Mohs procedure
1-2 years of additional training after residency
Exposure to rare tumor pathology, difficult tumor locations, and complex wound reconstruction
A minimum of 650 cases during training

Dr. Joseph Greco: A Top Mohs Surgeon Serving Sarasota and Beyond

Not only is Mohs micrographic surgery one of our primary services at Greco Dermatology; you can also be completely assured that you’re in excellent hands with Dr. Joseph Greco. As a top Mohs surgeon who is known for his Mohs work at UCLA — one of the premier hospital systems in the nation — he has been in the realm of skin cancer for 15 years, and has the experience and recognition needed to give you complete confidence in your treatment. Greco Dermatology is a premier Mohs center in Sarasota with cutting-edge therapies and a double board-certified Mohs surgeon and skin cancer specialist at the helm. If you’re in the Sarasota area and you’re interested to work with a fellowship-trained Mohs surgeon with unique and extensive experience in the field, we welcome you to schedule your consultation with us today.