Dermatologic Treatments

The Department of Dermatology at The Mount Sinai Hospital offers a variety of treatments, including Mohs micrographic surgery, reconstructive surgery, and cosmetic procedures. Our surgeons are actively involved in research, education, and advancement of in all the aspects of dermatologic surgery.

Most procedures are performed in outpatient surgical suites including: skin cancer management, Mohs surgery, scar revisions, neurotoxins, fillers, liposuction, fat transfer, blepharoplasty, and the latest laser procedures.

Dermatologic treatments offer at The Mount Sinai Hospital include, but are not limited to:

  • Blepharoplasty (eyelift & removal of “bags”): Surgery of the upper and or lower eyelids is a safe and effective outpatient procedure that can be performed under local anesthesia with minimal discomfort. Patients looking to rejuvenate the skin around their eyes often turn to this procedure for a more rested and alert appearance. The procedure typically involves removing redundant or sagging skin of the eyelids as well excess fatty deposits if puffiness or “bags” have developed with aging. Under local anesthesia incision lines are made in a manner that conceals the scar in the natural creases of the eyelids. For the upper eyelids the incision lines are hidden in the natural crease and for the lower eyelid the incision lines are made just below the lash lines. Hiding the incision lines within natural structures of the eyelid is what gives this surgery the reputation as a “scarless” procedure. Through these incisions, fat deposits can be removed or repositioned, muscles tightened and excessive skin removed. For lower eyelids, a transconjunctival incision that is placed within the inside of the lower eyelid is an alternative approach to performing the surgery. After the incision lines are created and the surgery is performed the eyelid incisions are closed with removable or absorbable sutures combined with skin adhesives. Sutures are removed seven days after the procedure and swelling and bruising can persist for three to 10 days after the surgery.

  • Dermabrasion is a mechanical refinishing of the skin’s top layer with the goal of smoothing the overall texture of the skin. It is also used to smooth out and decrease the thickness of surgical or traumatic scars. Dermabrasion removes the outermost layer of skin by using medical-grade sandpaper, a rough wire brush, or a burr containing diamond particles, attached to a motorized handle. Following the procedure, a person who has undergone dermabrasion will be red and swollen. The skin can be sensitive and slightly pink for a few weeks after the procedure is performed.

  • Laser treatment of leg veins: Many factors play a role in the development of unsightly leg veins. The most common cause of leg veins is the presence of being incompetent venous valves leading to elevated pressure and pooling of blood inside the veins. Other factors include age, weight, pregnancy, trauma, and genetics. Along with the traditional treatments, the Dermatology Department at The Mount Sinai Hospital offers laser therapy as an alternative method to using needles in treating this common condition. Through the use of laser-generated heat, precise damage and closure of the targeted veins occurs just beneath the skin surface. For a favorable outcome multiple sessions may be required. Recovery and return to daily routine is relatively quick after the laser treatment.

  • Liposuction, also known as lipoplasty or body contouring, is a cosmetic surgical technique that removes unwanted fat from different sites on the body, including abdomen, thighs, buttocks, hips, knees, arms, and neck. Liposuction is not a replacement for regular exercise and good eating habits, and the best candidates for such procedures are individual with relatively normal weight that have a body with disproportionate contours due to localized fat deposits. With power assistant liposuction, the surgeon is able to remove fat more effectively with minimal trauma and pain for the patient. Skin with diminished elastic tone due to stretch marks, weight loss, or aging will not reshape itself to new contours and may require additional surgical techniques to remove excess skin. The procedure is performed with tumescent anesthesia and moderate sedation. Patient recovery is relatively fast and most patients can return to work in a few days.

  • miraDry® for excessive sweating: Excessive underarm sweating and/or sweating in any other body area is called hyperhidrosis. This common condition may have a negative impact for individuals during social situations and daily activities. One of the latest, FDA-approved techniques in treatment of hyperhidrosis is miraDry. This treatment provides a non-invasive, long-lasting (if not permanent) solution by delivering energy capable of causing destruction to sweat producing glands. This procedure is accomplished in two sessions, three months apart. The procedure lasts about one hour and is performed with local anesthesia. Studies have shown that patients treated with miraDry experienced an average sweat reduction of 82 percent. Over 90 percent of patients were extremely pleased with the results.

  • Mohs micrographic surgery is one of the most effective ways to treat skin cancers located on cosmetically sensitive areas of the body, particularly the face. Mohs surgery allows complete cancer removal, while minimizing the amount of healthy tissue lost and maximizing the functional and cosmetic outcome. When employing Mohs surgery, the physician uses a microscope to trace the cancer down to its roots. The procedure is particularly effective in treating patients with high-risk, complex, and recurrent cancers and provides clearance rates approaching 100 percent for basal cell carcinoma and squamous cell carcinoma – exceeding the rates for traditional surgical excision, radiation therapy, electrodessication and curettage, cryosurgery, photodynamic therapy, and topical chemotherapeutic agents. Other indications for this procedure include large tumors, unclear clinical margins, aggressive histologic patterns, and immunosuppression. Our team includes dermatologic surgeons who are fellowship-trained Mohs surgeons and member of the American College of Mohs Surgery, which is extremely important given the complex nature of this procedure.

  • Phototherapy: Our phototherapy suite is among the busiest in the world. We offer a wide range of treatment options, including broadband UVB, narrowband UVB, PUVA, the excimer laser, and the Levian system for scalp psoriasis. Our phototherapy team is experienced in the treatment of a variety of conditions, including psoriasis, vitiligo, mycosis fungoides, and pruritus. We offer therapy to the whole body or to specified areas, such as the palms and soles. We also offer soak PUVA, in which one can soak in Oxsoralen instead of receiving it internally.

  • Reconstruction following Mohs surgery: After undergoing Mohs surgery, the patient will be left with a surgical wound; however, there are several options for healing depending on the location, size, and depth of the defect. In some cases, the surgeon will allow the surgical wound to heal on its own, a process known as secondary intension healing. For instance, some areas of the body, such as the ear or scalp, heal extremely well without any need for additional surgery, stitching, or extensive post-operative wound care. When the surgical wound is too large or deep to heal on its own, reconstructive surgery may be required. Most skin cancer surgeons have training in complex reconstructive surgery and can perform the procedure immediately or within a few days following the Mohs skin cancer removal; others may request that the reconstruction be performed by another board certified reconstructive surgeon they trust. Options for reconstruction include: 1) primary closure, in which the skin of the Mohs surgical wound is pulled together and sutured closed with minimal changes to the structures surrounding the wound; 2) grafting, in which skin from another area of the body is used to cover up the wound created by the Mohs surgery; and/or 3) flap reconstruction, in which nearby skin is moved to conceal the wound created after the Mohs technique. In all of these cases, stitching is needed to close the wound and will require follow-up appointments (to monitor skin healing and any scar formation) and at-home wound care. Depending on the location of the surgery, patients are asked to schedule an appointment for suture removal in one to two weeks.

  • Resurfacing: The appearance of a sun-damaged skin, wrinkles, scars, uneven skin tone and pigmentation, and acne and surgical scars can be significantly improved by treatment with the laser therapy. The Mount Sinai Hospital offers at least two kinds of resurfacing treatments:

    • Fractionated Co2 resurfacing: Total FX® is a state-of-the-art laser device which enables patients to receive excellent results by treating only a fraction of the skin but not sacrificing results. This technology treats the upper layers of the skin to improve the pigmentation, while the also treating the deeper layers to stimulate collagen growth and remodeling. The procedure takes about 30 minutes, after 60 minutes with a topical anesthetic. During the procedure, the patient will feel warm sensation that continues for several hours after, although this can vary between patients. After the procedure, the patient will begin to notice improvement to the fine lines and wrinkles and pigmentation. Most patients experience improvement of the tone and texture of the skin for up to six months.

    • Non-ablative resurfacing: Fraxel® is non-ablative resurfacing laser therapy that targets the skin with microscopic laser columns that penetrate deep into the skin and enhances remodeling of collagen. It has very few side effects and low downtime, but it usually requires several treatments to produce optimal results. During the first 24 hours after the procedure, patients will feel as though their skin is sunburned. The skin will appear pink, but patients can wear makeup to cover up the sunburned appearance.

  • Scar revision: Whether it is a surgical or traumatic scar, there are several approaches that can be taken to improve the physical appearance of a scar. While scar revision can never completely remove a scar, a multi-faceted approach can lead to significant improvement. Scar revision can involve topical treatments with creams that contain silicone or intralesional injections with corticosteroids to decrease the thickness and itching. Lasers can also be used to improve the appearance of many scars. The scar redness is often treated with a Pulse Dye laser (V-beam), while the texture of scar can be improved with fractionated Co2 laser (Total Fx). Occasionally, scars may have irregularities that are best treated with dermabrasion. Re-excision and suturing of a scar is sometimes required to either change the direction or place the scar in a natural boundary, which makes the scar less noticeable.

  • Tattoo removal laser treatment: Modern advancements of laser technology have made tattoo removal more practical and with fewer complications. Most optimal results are achieved through the use of the Q-Switched Nd:YAG and Ruby laser to remove unwanted tattoos by emitting wavelengths of light that are absorbed by the tattoo pigment in the skin, leading to thermal damage and safe removal of most of the tattoo pigment by the immune system with less pain and scarring compared to older methods. Several factors influence the number of treatment sessions and effectiveness of the laser used to remove a tattoo including the size, color, type, and depth of the tattoo pigment and skin texture and color. A local anesthetic may be used prior to the procedure to alleviate pain, and, on average, it takes several days to heal after the removal session.

 


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Mount Sinai Dermatology
5 East 98th Street, 5th Floor
New York, NY 10029
Tel: 212-241-9728

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