MOHS Surgery

[George1938]

Anyone have experience on the subject? Specifically with Dr.David Casper?

[tedquick]

Both my daughter and I have had MOHS procedures in the past. It is a relatively simple surgery. While I have not had MOHS with Dr. Casper he is my dermatologist here in TV and I have complete trust in him. I recently completed radiation treatment for two spots, one on my nose and one on my shoulder. I had the choice of doing MOHS but chose instead the radiation. I have had quite a bit of experience with him and I believe that you can trust him with whatever it is that you need to have done. Best of luck.

[JoMar]

When in PA my dermatologist was a Mohs surgeon and I have the scars to prove. When I moved here I wanted a doctor that had that capability inside his/her practice which is why I am a patient with Dr. Casper. His practice is hard to get into (guess a lot feel as I do) but I find him knowledgeable, accomplished and caring. I recently had surgery which required 7 stitches. Dr. Casper personally did a followup call at 9PM to check on my condition. At this juncture, I am totally satisfied. If you want details on what the surgery entails you can google it and get more detail then you will get on here.

[jimnc]

Both my husband and I have had MOHS surgery. My husband had MOHS with Dr. Casper and everything went fine. He was given the option of radiation instead of MOHS but chose MOHS. In my opinion it is the best way to go. The Dr. may need to cut more than once but when you leave the office you can feel confident that all the cancerous cells have been removed. That peace of mind is priceless. Dr. Casper comes highly recommended. Try not to worry. MOHS is a more common procedure than you might think. You should be just fine.

[MikeV]

My wife had MOHS surgery below the corner of her eye by Dr. Casper. All is well now and he did a great job.

[Doctor Who]

MOHS is unpleasant no matter who does the surgery. Dr. Casper has done several on me. While I consider him to be a wonderful dermatologist the treatment and recovery time are the same as any other dermatologist. Where possible I select the radiation treatment. It is time consuming (15 visits) but it is a good alternative. In some cases MOHS may be necessary and along with it the possibility of some plastic surgery. I have had substitute skin taken from my ear and chest and applied to my nose; in that case by a different physician. Its always best to be in good hands and Dr. Casper is a very caring physician.

[George1938]

Thank you to all who replied. Total positive agreement, I might add

[manaboutown]

I had a Mohs Procedure done on a melanoma by a dermatological plastic surgeon. It went very well and I am happy with the results. What I might add to the above posts is that I was a compliant patient and rigorously adhered to the surgeon's instructions about frequently cleaning/tending/dressing the wound and changing the bandage twice a day as prescribed. It took weeks to heal because the wound on my scalp was so large, initially the size of a stack of three half dollars.

[villagerjack]

Both my daughter and I have had MOHS procedures in the past. It is a relatively simple surgery. While I have not had MOHS with Dr. Casper he is my dermatologist here in TV and I have complete trust in him. I recently completed radiation treatment for two spots, one on my nose and one on my shoulder. I had the choice of doing MOHS but chose instead the radiation. I have had quite a bit of experience with him and I believe that you can trust him with whatever it is that you need to have done. Best of luck.


Be mindful that the radiation treatment with Villages Insurance will cost you 20% copayment which could be in the hundreds of dollars. They do not tell you this when they push this as an alternative.

Also a good idea to get a second opinion on these surgeries. I went to a different doctor when I was out of Town and the second doctor said I did not need the surgery. He treated it with liquid Nitrogen and today it is fine. There is entirely too much cutting here in The Villages IMO.,

[tedquick]

Be mindful that the radiation treatment with Villages Insurance will cost you 20% copayment which could be in the hundreds of dollars. They do not tell you this when they push this as an alternative.

Also a good idea to get a second opinion on these surgeries. I went to a different doctor when I was out of Town and the second doctor said I did not need the surgery. He treated it with liquid Nitrogen and today it is fine. There is entirely too much cutting here in The Villages IMO.,

I was told that there could be up to a $300.00 co-pay. There was none.

I think getting a second opinion is an interesting idea. I may actually do that following my next regularly scheduled appointment even though my appointments here have been nearly identical to what I experienced when I was still living in Omaha.

[villagerjack]

I was told that there could be up to a $300.00 co-pay. There was none.

I think getting a second opinion is an interesting idea. I may actually do that following my next regularly scheduled appointment even though my appointments here have been nearly identical to what I experienced when I was still living in Omaha.

Good for you but the Villages Health Insurance has a 20% co-pay.

[JoMar]

I have United Healthcare PPO in the Villages Health System.....my copay is 50.00 for specialists. Not sure where the 300.00 comes from.

[JoMar]

I was told that there could be up to a $300.00 co-pay. There was none.

I think getting a second opinion is an interesting idea. I may actually do that following my next regularly scheduled appointment even though my appointments here have been nearly identical to what I experienced when I was still living in Omaha.

A curiosity question, if you get a second opinion that is different from the original opinion what do you do? I always believed that if you go for a second opinion it would be to doctor or hospital that has significantly more accreditation, experience or a National recognition as an expert in the field. Going to a peer only puts you in the position to make a decision which begs the question, how do you do that if they disagree? In TV and dermatology who would you go to? And, if you think the doc that is giving you the second opinion is better than the original doc why aren't you going there initially? Just curious?

[Shimpy]

I always believed that if you go for a second opinion it would be to doctor or hospital that has significantly more accreditation, experience or a National recognition as an expert in the field. Just curious?
Most people I believe, like myself, are seeking an opinion that they are looking for.

[JoMar]

Most people I believe, like myself, are seeking an opinion that they are looking for.

Isn't that a bit dangerous?

[villagerjack]

I have United Healthcare PPO in the Villages Health System.....my copay is 50.00 for specialists. Not sure where the 300.00 comes from.

Have you had any X-rays or radiation? The charge is 20% under the Villages Health Plan.

[villagerjack]

A curiosity question, if you get a second opinion that is different from the original opinion what do you do? I always believed that if you go for a second opinion it would be to doctor or hospital that has significantly more accreditation, experience or a National recognition as an expert in the field. Going to a peer only puts you in the position to make a decision which begs the question, how do you do that if they disagree? In TV and dermatology who would you go to? And, if you think the doc that is giving you the second opinion is better than the original doc why aren't you going there initially? Just curious?

During 2014/2015, I visited three separate Dermatologists. One up North and two in The Villages as I had to change doctors due to an insurance change. I let each doctor make his/her own decisions. This went on for close to a year. Each doctor took their own biopsies on entirely different areas, some more than others but during the course of the year, each doctor concentrated on different areas and ignored other areas that the other doctors thought were important. On at least one occasion, when a doctor wanted to biopsy, I told him I did not have the time and to spray it instead with LN. It was gone by the time I visited the next doctor.

On another occasion, I had a biopsy taken and was informed it was Squamous. Since I was headed up North for the summer, I could not have the surgery in The Villages. During the summer, I received a letter from the doctor telling me that if I did not have the surgery, it could spread and result in death. I showed this area to my Northern Dermatologist and he looked at it carefully, sprayed it with LN and it went away completely in two weeks.

I have been going to a Dermatologist religiously 4 times a year for at least the last 20 years and only in the last 5-6 years have I noticed a large increase in requests for surgery. In the first 15 years I had one surgery. I have had many since then but this last year visiting 3 separate doctors made me very cautious.,I am sorry to say that for the first time in 20 years, I am now beginning to question the need for some of the surgeries from Dermatologists not just in The Villages but some here apparently do their "fair share" even the "good" ones getting great recommendations.

I don't know what the solution is for you. Perhaps to go to another doctor as a new patient and get a body exam and see if he comes up with the same diagnosis and areas as the other doctor did. Personally, I am very skeptical of all the dermatologists. There is way too much surgery done.MY OPINION ONLY.

[2BNTV]

Have you had any X-rays or radiation? The charge is 20% under the Villages Health Plan.

Or possibly, outpatient surgery charge?

[AJ32162]

In my opinion dermatology is more art than science, particularly when it comes to visually determining whether or not a skin lesion is cancerous or benign. I have had four skin cancers to date, three of which looked benign on visual inspection by three different dermatologist. The only accurate way to determine if a lesion is cancerous or not is through a biopsy. If performed correctly a biopsy will leave only a minimal scar, barely noticeable. Personally, I would rather have ten too many biopsies than one too few.

I did have a lesion frozen above my right eye about five years ago and it healed completely, or so I thought. Recently, I developed a lesion in the same spot which I had biopsied. The result was a deep basal cell carcinoma which Dr. Casper said had probably been growing for several years. He removed it with MOHS and said the surgery would have been less invasive, had it been detected earlier (five years ago?) through a biopsy instead of being frozen with LN.

So, if a dermatologist has any doubt as to the malignancy of a suspicious lesion, I request a biopsy. The downside is that several biopsies have proven to be unnecessary...and I can live with that as they have left no noticeable scars. Anyone who has delayed treatment for skin cancer can attest to just how destructive and disfiguring it can be. Caught and treated early it is your best chance for a cure and better cosmetic results. Well, that's just one man's opinion, make of it what you will.

[JoMar]

During 2014/2015, I visited three separate Dermatologists. One up North and two in The Villages as I had to change doctors due to an insurance change. I let each doctor make his/her own decisions. This went on for close to a year. Each doctor took their own biopsies on entirely different areas, some more than others but during the course of the year, each doctor concentrated on different areas and ignored other areas that the other doctors thought were important. On at least one occasion, when a doctor wanted to biopsy, I told him I did not have the time and to spray it instead with LN. It was gone by the time I visited the next doctor.

On another occasion, I had a biopsy taken and was informed it was Squamous. Since I was headed up North for the summer, I could not have the surgery in The Villages. During the summer, I received a letter from the doctor telling me that if I did not have the surgery, it could spread and result in death. I showed this area to my Northern Dermatologist and he looked at it carefully, sprayed it with LN and it went away completely in two weeks.

I have been going to a Dermatologist religiously 4 times a year for at least the last 20 years and only in the last 5-6 years have I noticed a large increase in requests for surgery. In the first 15 years I had one surgery. I have had many since then but this last year visiting 3 separate doctors made me very cautious.,I am sorry to say that for the first time in 20 years, I am now beginning to question the need for some of the surgeries from Dermatologists not just in The Villages but some here apparently do their "fair share" even the "good" ones getting great recommendations.

I don't know what the solution is for you. Perhaps to go to another doctor as a new patient and get a body exam and see if he comes up with the same diagnosis and areas as the other doctor did. Personally, I am very skeptical of all the dermatologists. There is way too much surgery done.MY OPINION ONLY.

I go to the dermatologist 4 times a year, for the last 15 years. Dr. Casper was consistent with what my northern guy did, and found. I do a full body exam yearly (probably because that's all the doc can handle :) ). My question was, and I believe was answered, is that peer second opinions are a search to find a doctor that gives the patient the diagnosis they want. For whatever reason, you had more faith or trust in your northern guy or had little or no trust in your guy down here. Either way, your concern was that there were too many surgeries performed. Your northern guy's diagnosis justified that so you went with him. As a previous poster stated, I think that happens more that we think. I might have asked the two docs to discuss what they found for a meeting of the minds. Both my wife and I have taken advantage of second opinions but they have always been up the chain, not peer to peer.

[tedquick]

A curiosity question, if you get a second opinion that is different from the original opinion what do you do? I always believed that if you go for a second opinion it would be to doctor or hospital that has significantly more accreditation, experience or a National recognition as an expert in the field. Going to a peer only puts you in the position to make a decision which begs the question, how do you do that if they disagree? In TV and dermatology who would you go to? And, if you think the doc that is giving you the second opinion is better than the original doc why aren't you going there initially? Just curious?

JoMar, that is an excellent question. After thinking about it more, as long as I'm seeing Dr. Casper I will not go for another opinion. I keep reflecting back to the time that he kept looking at a spot and finally said "I think we should biopsy this spot right here". He did but it turned out that it was benign. I was, and as I reflect on that, impressed with what I will call a very careful approach. I do not think that he freezes more than is necessary nor do I think he biopsies more than he should. I simply trust him.

[villagerjack]

Or possibly, outpatient surgery charge?

20% Co Pay for Radiation.

[JoMar]

JoMar, that is an excellent question. After thinking about it more, as long as I'm seeing Dr. Casper I will not go for another opinion. I keep reflecting back to the time that he kept looking at a spot and finally said "I think we should biopsy this spot right here". He did but it turned out that it was benign. I was, and as I reflect on that, impressed with what I will call a very careful approach. I do not think that he freezes more than is necessary nor do I think he biopsies more than he should. I simply trust him.

So do I.

[phillygirl]

Has anyone used dr Casper for MOHs on their face then dr Ahumada a plastic surgeon for the stitches/closing up? Thank yiu

[fl boomer]

I'm a 6 year melanoma survivor, and I once asked my Dermatologist about using LN on spots, and whether that would keep them from turning into future skin cancers. She cautioned me and said that a doctor has to be careful what spots they freeze because there can be underlying skin cancer which might go undetected and continue to spread.