ARYX Soma Atelier

Skin Cancer: Diagnosis, Margins and Reconstruction in Mexico City

In a conventional excision, less than 1% of the true margin is examined. With micrographic control, 100% is examined before closing.

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What it is and how it works

treating a skin lesion properly has three moments, and each has its own owner. Diagnosis, performed by the dermatologist or dermato-oncologist: identifying what it is, classifying it and taking a biopsy when appropriate. Margin control, which confirms no tumor remains before closing. And reconstruction, performed by the plastic surgeon, respecting the aesthetic units of the face and the function of eyelids, nose, lips and ear. Working separately produces the two classic errors: removing too much and leaving an unnecessary defect, or removing too little and having a recurrence beneath a reconstruction already done.

What it treats, in detail

How we do it here

what defines your outcome is how the margins are studied, and it is something almost no patient knows. In a conventional excision the tissue is cut in vertical slices and generally less than 1% of the true margin is examined: that is why a report stating “clear margins” after a narrow excision can be inaccurate, with recurrences described up to 38%. Complete margin control techniques, such as Mohs micrographic surgery, examine 100% of the deep and lateral margins during the same procedure, and only once they are clear is reconstruction performed. And a house principle we apply throughout the clinic: no pigmented lesion is treated with laser without a prior diagnosis.

Who it’s for

if you have a lesion that changed in size, shape or color, one that bleeds or does not heal, or a skin cancer diagnosis. Also if you have many moles or a family history and want serious surveillance.

Who it’s not for

it does not apply as an aesthetic contraindication, because this is pathology. What we do define is the route: if your case requires additional oncologic treatment, such as radiotherapy or systemic therapy, it is referred.

What to expect

  1. 01

    most lesions are resolved under local anesthesia as an outpatient.

  2. 02

    Large defects or complex reconstructions may require sedation or general anesthesia.

  3. 03

    Afterward, wound care, strict sun protection and dermatologic follow-up, which is part of the treatment: anyone who has had skin cancer is at higher risk of having another.

Risks and what we tell you honestly

there can be recurrence, which is lower with complete margin control; infection, dehiscence, partial necrosis of a flap or graft, and scarring. And something important: not every lesion requires Mohs. For small, well-defined, low-risk primary lesions, excision with adequate margins produces satisfactory results. Indicating Mohs for everything is not better medicine, it is overtreatment.

Beyond aesthetics

this is oncologic treatment, the benefit is curative. Complete margin control techniques have the highest cure rates: up to 99% in new basal cell carcinoma cases and 95 to 99% in squamous cell. In high-risk head and neck carcinomas, recurrence was 3.1% with micrographic control versus 14% with conventional surgery. To that adds preserving function and appearance in visible areas, which on the face is decisive.

Myth vs reality

Myth

“They told me the margins were clear, so it is resolved.”

Reality

it depends how they were studied. If the lesion was excised with a narrow margin and examined by the conventional method, only a minimal fraction of the true border was reviewed, which is why recurrences up to 38% are reported in that scenario. That is why, in high-risk lesions or on the face, complete margin control changes the prognosis.

Book your consultation, and if you have a lesion that changed, do not let it wait.

Consultation with a specialist physician

This consultation carries a fee, which is not credited toward treatment.

Advisory session with our team

Complimentary. We answer questions about process, estimated pricing and travel logistics.