Board Certified SpecialtiesDermatology & Diseases of the Skin, Hair, & Nails

Mohs Micrographic Skin Cancer Surgery

Bachelor of ArtsSumma Cum Laude, Phi Beta Kappa

Washington Jefferson CollegeWashington, Pennsylvania

Doctor of MedicineWest Virginia University Medical Center

Morgantown, West Virginia

Intern, Internal MedicineMedical University of South Carolina

Charleston, South Carolina

Resident, DermatologyEmory University Hospitals

Atlanta, Georgia

Chief Resident, DermatologyEmory University Hospitals

Atlanta, Georgia

Fellow, Mohs Micrographic and Laser SurgeryScripps Clinic and Research Foundation

La Jolla, California

FellowAmerican Academy of Dermatology

American Society of Dermatologic SurgeryAmerican Society for Laser Medicine and Surgery

American College of Mohs Surgery

If you have been diagnosed with skin cancer,you may be frightened — wondering how thismight have happened, what you can do aboutit, and above all — whether you’re in seriousdanger. You’re not alone. More than 1 millionpeople in the United States are diagnosedwith skin cancer each year, and most haveprobably felt the same way you do.

A diagnosis of skin cancer is cause for concern— if left untreated, the disease can continueto progress. However, it needn’t be cause forpanic. Skin cancer is not necessarily lifethreatening nor does its therapy have to bedisfiguring. Advanced treatment is availablethat offers the highest potential for cure whileminimizing the cosmetic impact — even ifprevious treatments have failed.

We feel privileged that you have selected us todeliver your skin health care. Your trust andvote of confidence are highly valued. Ouroffice staff will endeavor to render services toyou in a caring and professional manner.

A. Thomas Bundy, MD, FAAD, FACMS is certified by theAmerican Board of Dermatology and is a Fellow of theAmerican College of Mohs Surgery. Practicing dermatologicsurgery for over 10 years, he is a leader in the field of lasersand Mohs surgery. He served as chief resident in dermatologyat Emory University in Atlanta and completed a one-yearFellowship in Mohs and Laser Surgery at the renowned ScrippsClinic and Research Foundation in La Jolla, California. Dr.Bundy has authored numerous articles for various medicaljournals and has spoken as a guest lecturer for both local andnational professional meetings. He regularly attends andspeaks at seminars and courses pertaining to skin cancer,reconstructive techniques and cosmetic laser surgery.

A.Thomas Bundy, MD, FAAD, FACMSBoard Certified Dermatologist

and Mohs Micrographic Surgeon

Advanced Fellowship TrainingMohs & Cosmetic Laser Surgery

843.689.9200www.hiltonheaddermatology.com

843.689.9200www.hiltonheaddermatology.com

H I L T O N H E A D I S L A N D15 Hospital Center Blvd | Medical Quarters, Suite One | Hilton Head

B L U F F T O N - O K AT I ELegacy Center | 4 Okatie Center Blvd South, Suite 202 | Okatie

MOHS MicrographicSkin Cancer Surgery

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Hilton HeadMedical Center

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Cancer Center

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H I L T O N H E A D

A . T H O M A S B U N D Y, M D , FA A D , FA C M S

Mohs SurgerySkin Cancer Removal

Preserving The Most HealthyTissue and Achieving The Highest

Known Cure Rate to 99%

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1. Eat a light breakfast or lunch the day of surgery.You may have decaffeinated coffee, juice, andtoast.

2. Take your regularly prescribed medications. Aspirinand Aspirin-containing medications (Alka Seltzer,Decongestants, Anacin, Advil, Motrin or Bufferin)should not be taken 7-10 days prior to surgery.Please let us know upon receiving this checklist ifyou are taking other arthritis medicine, pain relieversor blood thinners. If you have questions, please callfor instructions. If a physician has placed you onthe Aspirin, please let us know so that we mightdiscuss this with him or her.

3. If you need an antibiotic prior to surgical proceduresor dental work, please make the necessaryarrangements with your physician to order it.

4. A container for contact lens or dentures should bebrought, if you will be having surgery in this area.

5. Please try not to drink any alcoholic beveragesthree days prior to your surgery. Alcohol aggravatesbleeding problems.

6. On the day of surgery, you should be accompaniedby a family member or friend. Medicated patientswill not be allowed to drive themselves home. Allpatients must be escorted when leaving the officeafter surgery. If we need to call for your ride afterthe procedure, please bring the names and tele-phone numbers.

7. You will be here for several hours during yoursurgery day while the tissue is processed. It is agood idea to bring in a book or magazine with you.

8. Please try not to smoke one week prior to thesurgery. Smoking and blood levels of nicotine caninterfere with wound healing.

9. Please call our office if you get sick between nowand the time of your surgery or if you have anyadditional questions.

What is Mohs Micrographic Surgery?

Mohs micrographic surgery is named in honor of the physi-cian who developed the technique, Dr. Frederic Mohs.Although developed in the early 1940’s, Mohs surgery didnot come of age until the late 1970’s when technicalimprovements and refinements made it a safe and highlyeffective means of treating skin cancers including basalcell carcinomas, squamous cell carcinomas andoccasionally melanomas.

Why is Mohs Surgery Different?

Mohs surgery differs from standard excision in that thephysician functions as surgeon and pathologist performingmicroscopic control utilizing multiple thin layers of tissueprocessed along a grid pattern and carefully mapped. Thelocation of all tumor roots can be pinpointed with accuracyand removed with an exceedingly high degree of precisionso that all cancerous tissue has been eradicated. Mohsmicrographic surgery is now universally recognized as themost efficient and cost-effective method for treatingskin cancers.

When is Mohs Surgery Indicated?

Mohs surgery is especially effective inremoving cancers of the face, hands andfeet and other cosmetically sensitive areasbecause it can eliminate virtually all of thecancerous tissue while causing minimaldamage to the surrounding normal skin.It is also ideal for removing recurrenttumors, residual tumors or very ill-definedskin cancers.

What is the Advantage of Mohs surgery?

Mohs surgery provides the highest known cure rate inremoving cutaneous malignancies. One study at the MayoClinic showed a 98% cure rate in removal of skin cancersfrom over 3,300 patients. Moreover, since only the cancer-ous tissue is removed, the greatest amount of normal skinis allowed to remain thereby creating the smallest woundpossible. The smaller the wound, the greater the chancefor an excellent cosmetic result after the wound hascompletely healed.

How is the Surgery Conducted?

Commonly performed on an outpatient basis with localanesthetic, the surgery generally begins in the morning andis finished that day unless the tumor is exceedinglyextensive. Due to the very thin layer-by-layer removal withlaboratory preparation and microscopic examination, agreat deal of precision is utilized often requiring a fewhours. Today’s fellowship-trained Mohs micrographicsurgeons often complete cosmetic reconstructive surgery,but occasionally another physician may be consulted.

Who Performs Mohs Micrographic Surgery?

American College of MOHS Surgerycurrently recognizes about 50 trainingcenters in the United States where thetop dermatology graduates receive anadditional one to two year comprehensivefellowship in micrographic surgical tech-niques, histopathology and dermatologicplastic surgery reconstruction specificallydealing with all forms of skin cancer.Having completed the additional training,

this physician then becomes eligible for membership as aFellow in the National College.

Step 1 The roots of a skincancer may extend beyondthe visible portion of thetumor. If these roots are notremoved, the cancer will recur.

Step 2 The visible portion ofthe tumor is surgicallyremoved.

Step 3 A layer of skin is thenremoved and divided intosections. The Mohs surgeonthen color codes each ofthese sections with dyes andmakes reference marks onthe skin to show the sourceof these sections. A map of thesurgical site is then drawn.

Step 4 The undersurfaceand edges of each sectionare then microscopicallyexamined for evidence ofremaining cancer.

Step 5 If cancer cells arefound under the microscope,the surgeon marks their loca-tion onto the “map” andreturns to the patient toremove another layer of skin— but only precisely wherethe cancer cells remain.

Step 6 The removal processstops when there is no longerany evidence of cancerremaining in the surgical site.Because Mohs surgeryremoves only tissue contain-ing cancer, it ensures that thehealthy tissue is kept intact.

Dr. Bundy has treated over 20,000 skin cancers with an exceedingly low rate of tumor recurrence – a 99% five-yearcure rate for cutaneous malignancies. This has been possible largely in part due to the micrographic techniquesemployed locally as an in-office procedure with Mohs surgery. Fellowship-trained in lasers and skin cancer, Dr.Bundy utilizes skills in pathology and plastic reconstruction. He is a member of a select group of about 900 suchspecialized surgeons in the United States who have completed additional training of 13-14 years.

MOHS Micrographic Skin Cancer SurgeryPreoperative Instructions

Skin Cancer

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After Mohs Surgery

Reconstruction 3 Weeks

“One study at the Mayo Clinic showed a 98% cure ratein removal of skin cancers from over 3,300 patients.”

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