Mohs micrographic surgery is the most effective and precise treatment for most types of skin cancer. For that reason, it is important to select a fellowship-trained Mohs surgeon who is a member of the American College of Mohs Surgery (ACMS), such as Dr. Alysa Herman. One of the most highly regarded Mohs surgeons in Miami, Florida, Dr. Herman is exceptionally skilled in the specialized processes and techniques required for Mohs micrographic surgery. Because she limits her practice specifically to Mohs surgery and surgical dermatology, Dr. Herman has developed the abilities and experience needed to achieve an optimal outcome for her skin cancer patients.
If you've been diagnosed with skin cancer, you need a physician who is exceptionally qualified, experienced and compassionate. Dr. Herman is renowned among physicians and patients for her credentials and her dedication to patient care.
When choosing a surgeon to perform Mohs surgery it’s important to find one who is a fellowship-trained member of the American College of Mohs Surgery (ACMS). Being an ACMS member requires extensive training and experience that’s not matched by other skin cancer surgeons. After completing years of residency training, an ACMS member gets at least a full year of hands-on training performing the Mohs procedure during a fellowship supervised by a highly qualified instructor. In addition, to earn ACMS membership a fellowship-trained Mohs surgeon must:
Participate in a minimum of 500 Mohs surgery cases
Learn to accurately interpret slides of tissue samples that have been removed during Mohs surgery
Perform a wide breadth of reconstructions, ranging from simple closures to complicated multi-step repairs
Other Mohs surgery organizations don’t match the strict requirements used by the American College of Mohs Surgery.
Understanding Mohs Surgery
As a Mohs College surgeon, Dr. Herman has the high level of skills, knowledge, and experience required to precisely detect skin cancer and remove it while leaving the surrounding healthy tissue intact. Because this method immediately verifies the complete removal of the cancerous tissue, Mohs surgery offers the highest success rate of all skin cancer treatments – up to 99%. Dr. Herman has provided answers to common questions on her Mohs Surgery FAQs page.
Mohs Surgery Procedure
Dr. Herman meticulously performs this outpatient procedure according to the highest standards of quality and safety. Because she performs Mohs surgery in her Miami, Florida office, which is equipped with an on-site surgical suite and laboratory, Dr. Herman immediately prepares and microscopically examines each layer of tissue as it is removed. As a result, in most cases, Dr. Herman completes the surgery in a single day. However, the time required depends on the depth of the tumor and any reconstruction needed.
Dr. Herman begins by administering local anesthesia around the area of the skin cancer. By using local rather than general anesthesia, your recovery time is shorter and typically more comfortable. Dr. Herman then removes the visible tumor. She marks the edges by using colored dyes, and creates a “map” of the specimen.
Using the Mohs micrographic surgery technique, Dr. Herman removes a very thin layer of skin tissue. That tissue is processed onto microscope slides, which Dr. Herman examines to determine whether skin cancer cells are present. If cancerous cells are observed, Dr. Herman identifies and maps the microscopic cancer roots. She then removes an additional layer of tissue only in the area where the skin cancer is present, preserving the healthy skin.
If Dr. Herman detects any evidence of cancer remaining, she meticulously removes another thin layer of tissue from that area. In this way, she ensures that she removes only cancerous tissue, so that the maximum amount of healthy skin is preserved. Dr. Herman continues this process with extreme precision until she identifies healthy, cancer-free skin tissue, referred to as the “clear margins.”
Mohs Surgery: Step-by-Step
Because skin cancer’s roots can extend beyond the visible tumor, it’s important to remove them to minimize the risk of the cancer recurring. Mohs micrographic surgery’s impressive success rate is accomplished using the following steps:
Dr. Herman injects a local anesthetic into the treatment area.
She removes the visible tumor.
After removing a thin layer of tissue, Dr. Herman cuts it into sections and uses colored dyes to code them and maps the surgical site to correspond to these sections.
She then examines the undersurface and edges of the tissue using a microscope, checking for additional evidence of cancer.
If she detects cancer cells, she removes another layer of tissue specifically from the area where the cells are located, then repeats the process.
Dr. Herman continues surgically removing additional tissue only where cancer cells exist until she no longer detects evidence of cancer.
By limiting the removal of tissue to the location of cancer cells, healthy tissue remains intact.
Preparing for Your Procedure
Dr. Herman has provided the following guidelines to help you prepare for your procedure:
Enjoy your normal breakfast, and take any medications prescribed by your doctor, even aspirin.
Because Mohs surgery is an outpatient procedure, and uses local anesthesia, you will be able to drive yourself home or to work after your procedure.
If you feel that it would help you be more at ease, you are welcome to bring a friend or family member to provide you with support during the procedure.
You can plan on returning to work after your appointment.
Mohs Surgery Recovery
After the cancer has been completely removed, Dr. Herman discusses your options for healing and recovery. These options may include natural healing (granulation), stitching the wound together using a side-to-side closure, skin flap, or graft. Dr. Herman helps you understand your reconstruction options, and then utilizes her extensive experience and exceptional skills to provide you with the optimal outcome.
ABSOLUTELY a wonderful staff and Doctor. Always very accommodating. You are seen at your appointment time, not 2 hour later. Very considerate of your time and always available to answer any question. Dr. Herman is a very down to earth, beautiful young professional. She is a rare find in today's world. She really cares about her patients. Will not go anywhere else from now on for my MOH's.
I have found Dr. Alysa Herman to be extremely professional, a perfectionist when it comes to her surgery and her patient care is excellent. I have 100% confidence and satisfaction in this MOHs surgeon and would highly recommend her.
Excellent Dr. and staff, i went to Dr. Herman for mohs surgery and for other concerns about my skin due to abnormal results they were able to walk with me through the process and answer all my questions and concerns. I highly recommend them for mohs surgeries, skin concerns and 2nd opinions.
I took my mom here for a mole removal surgery. The building has a parking garage and plenty of (pay to park app) spaces on the street. Once you walk in, you sign in and head up to the 7th floor. Dr Herman has a beautiful office with modern decor, and ample space. The staff is bilingual in English/Spanish, they are beyond helpful. The secretaries are on top of everything, they were working non stop the whole time were there. Her PAs are very professional and have such sweet bedside manner.
My mom had her mole removed in less than an hour. The doctor was very thorough, explained the procedure and how to take care of it. Mom felt no pain, and had to be back to take stitches off in one week. We had no problem scheduling her for an early appt in 7days..
Came in for a consultation and walked out doing a procedure. That is how comfortable Dr. Herman and her staff made us feel. Dr Herman was very professional and took her time explaining everything thoroughly. Office is clean, modern and beautiful. Highly recommend her!
I was diagnosed with a Kerancanthenoma. Scary stuff. I then tried to find a surgeon for Mohs surgery to remove it. I found Dr. Herman. She was great. Her office is very nice, staff very helpful and Dr. Herman was great. She even gave me her cell number if I wanted to talk to her. Great results. If you need Mohs surgery, Dr. Herman is the greatest.
Dr. Herman and her staff are wonderful. She is a true professional and you can tell she likes was she does and cares. They speak with you not talk at you which is important when you dealing with positive results. She puts you a ease. Her staff is awesome. They are ALL respectfull of your time. If your appointment is at 10am, you are seen at 10 am not bounced around through different rooms. Highly, highly recommend.
Dr. Herman is honored as one of Miami's Top Doctors by Indulge Magazine, highlighting her as one of the city's few dermatologic surgeons specializing in Mohs micrographic surgery for skin cancer.