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Weekly Insight
Mohs micrographic surgery is the gold standard for treating skin cancer, offering cure rates exceeding 95% for most skin cancers. At Miami Skin Center in Coral Gables, Dr. Carolina Puyana, a board-certified Mohs surgeon, combines precision technique with meticulous tissue preservation. If you've been diagnosed with skin cancer or have suspicious growths in the Miami area, expert surgical evaluation can guide your treatment path.
Skin cancer is the most common form of cancer in the United States, affecting millions annually, especially in sunny South Florida where sun exposure is year-round. According to the American Academy of Dermatology (AAD), basal cell carcinoma and squamous cell carcinoma account for the vast majority of diagnoses. Mohs micrographic surgery offers unparalleled precision—the surgeon removes tissue in thin layers and examines 100% of the surgical margins under a microscope during the procedure. This real-time feedback means cancerous cells are completely removed while preserving healthy tissue, resulting in better cosmetic outcomes and lower recurrence rates compared to standard excision.
The procedure takes place in our Coral Gables office and typically lasts 2–4 hours, depending on tumor size and location. After administering local anesthesia, Dr. Puyana removes the visible tumor plus a thin margin of surrounding tissue. The specimen is immediately processed and examined microscopically on-site. If cancer cells remain at the edges, Dr. Puyana removes additional tissue from the specific area where cells were detected. This targeted approach continues until all margins are clear. Once the tumor is completely removed, Dr. Puyana reconstructs the wound using techniques that prioritize healing and aesthetic appearance. Many patients are surprised at how well-preserved function and cosmetics are after Mohs surgery, particularly on the face.
Mohs surgery is ideal for skin cancers on cosmetically and functionally sensitive areas—the face, ears, eyelids, nose, and hands. It's also the treatment of choice for aggressive tumors, poorly defined borders, recurrent cancers, and tumors in areas with prior radiation or scar tissue. The NIH recognizes Mohs as the most cost-effective approach for high-risk lesions, reducing the need for revision surgeries and long-term complications. In the Miami and Coral Gables area, where residents spend significant time in the sun, skin cancer risk is elevated. Dr. Puyana's expertise ensures that your treatment is as conservative as possible while being completely effective.
Regular skin cancer screening is essential in a sunny climate like Miami. The AAD recommends annual full-body skin exams, particularly for those with fair skin, a family history of melanoma, or multiple moles. During a screening at Miami Skin Center, Dr. Puyana examines your entire skin surface using dermoscopy—a magnified lens that reveals details invisible to the naked eye. Early detection of skin cancer dramatically improves treatment outcomes and may allow for simpler interventions. If a suspicious lesion is found, Dr. Puyana can perform a biopsy in-office to confirm diagnosis before proceeding with Mohs surgery or other treatments.
Q: Does Mohs surgery leave a scar? A: Yes, but Mohs minimizes scarring by removing only affected tissue and using precise reconstruction techniques. Scars are often smaller and less noticeable than those from traditional excision. On the face and hands, Dr. Puyana uses advanced reconstruction methods—layered closure, skin grafts, or flaps—to optimize healing and appearance.
Q: How long is recovery after Mohs surgery? A: Most patients return to normal activities within 1–2 weeks. The wound requires careful cleaning and antibiotic ointment for 1–2 weeks. Sutures are typically removed in 7–14 days. Sun protection is critical during healing to prevent complications and color mismatch.
Q: What's the recurrence rate for skin cancer treated with Mohs surgery? A: Mohs has a 5-year recurrence rate of less than 5%30737-6), compared to 10–15% for standard excision. This high success rate is why dermatologists and surgeons prefer Mohs for high-risk tumors and visible locations.
Q: Can I schedule a skin cancer screening in Coral Gables? A: Absolutely. Contact Miami Skin Center to book a full-body skin cancer screening with Dr. Puyana. We offer thorough dermoscopic exams and can arrange biopsies the same day if needed. Early detection saves lives and simplifies treatment.
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This page is educational. Specific treatment decisions are made during your visit with Dr. Puyana.

Written by
Dr. Carolina Puyana, MD
Double Board-Certified Dermatologist & Mohs Surgeon · Skin Cancer · Lasers · Cosmetic
Dr. Carolina Puyana is a double board-certified dermatologist and Mohs surgeon, recognized for both clinical excellence and academic distinction. She graduated with the Highest Honors at the top of her class from the University of Illinois Chicago College of Medicine, after earning her undergraduate degree from the University of Miami and her Master of Public Health from UM's Miller School of Medicine — also with the Highest Honors. A distinguished physician-scholar, Dr. Puyana has authored over 45 peer-reviewed publications with more than 300 citations, contributed to four major dermatology textbooks, and was awarded a National Institutes of Health research grant for her work on skin cancer disparities. Bilingual in English and Spanish, she founded Miami Skin Center to bring elite, evidence-based dermatology to South Florida — combining academic rigor with the personal attention every patient deserves.
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