Mohs Surgery: The Gold Standard Treatment for BCC and SCC

Why is Mohs Surgery considered the world's gold standard treatment for BCC and SCCs? Dr. Bryce Cowan explains the types of cancers that are typically treated with Mohs surgery, and why the procedure has such as high cure rate.

IL-23s: Psoriasis therapy overview

Biologics are protein-based medications that target specific parts of the immune system. IL-23 inhibitor specifically targets a type of cytokine called IL-23 and blocks cellular activity, which results in reduced inflammation that causes psoriasis.

Selecting from IL-23s

Tildrakizumab (Ilumya) is a brand-name biologic medication that’s used to treat moderate to severe plaque psoriasis. This drug is an interleukin (IL-23) inhibitor that’s very effective and works long-term to control the symptoms of psoriasis.

Tildrakizumab effectiveness

People with psoriasis are frequently frustrated over treatments that are ineffective for them, such as tumor necrosis factor biologics, phototherapy, or systemic drugs (such as methotrexate). IL-23 inhibitors, like tildrakizumab, can be an important and effective therapeutic option when patients do not respond to other treatments.

Tildrakizumab effectiveness related to trial results

After 12 weeks of treatment with tildrakizumab (Ilumya), over 50 percent of patients can be cleared of their psoriasis. This biologic drug was approved in Canada in October 2021.

Tildrakizumab: the Patient Journey

Unlike many other psoriasis treatments, tildrakizumab can be used in higher-risk populations, such as in the elderly or those with psoriasis in addition to other health conditions like inflammatory bowel disease (IBD) or psoriatic arthritis.

Tildrakizumab candidates

Unlike many other psoriasis treatments, tildrakizumab can be used in higher-risk populations, such as in the elderly or those with psoriasis in addition to other health conditions like inflammatory bowel disease (IBD) or psoriatic arthritis.

General thoughts on Tildrakizumab

With the availability of tildrakizumab (Ilumya), an interleukin-23 (IL-23) inhibitor, dermatologists are very optimistic about the continued success of this biologic drug used to treat psoriasis patients.

Tildrakizumab long-term effectiveness

Research has shown high levels of effectiveness are maintained for 5 years and beyond with tildrakizumab (Ilumya), an interleukin-23 (IL-23) inhibitor.

Managing patients on Tildrakizumab

Tildrakizumab (Ilumya), an interleukin-23 (IL-23) inhibitor offers a convenient dosing schedule. Treatment is administered by subcutaneous injection at start of treatment, after 4 weeks, followed by every 12 weeks thereafter.

Introduction to Mohs Surgery

Mohs surgery is an advanced technique for removing skin cancers that combines histological analysis under a microscope at real-time with surgical excision.

Mohs surgery in Canada, Numbers and Facts

In Canada, there are only a very limited number of qualified Mohs surgeons at this stage, but that number is growing. The health care system in Canada is run at the provincial level, and currently there are only a limited number of facilities where Mohs surgeons can practice at.

Alternatives to Mohs Surgery

In this video Dr. Cowan explains common scenarios where a doctor might not recommend Mohs Micrographic surgery, and might opt for another treatment modality instead.

The Controversy Surrounding Melanoma and Mohs Surgery

Patients often wonder why Mohs is not the standard treatment for invasive melanoma, the most dangerous of skin cancers. Dr. Cowan explains why the use of Mohs surgery is considered controversial for treating invasive melanomas.

Understanding Facial Aging: Non-Linear Aging Process

Why is it that some people (other people!) seem to age slower? It's not fair! Plastic surgeon Dr. Bryce Cowan explains the complexities and factors that affect the timeline of aging, in the first part of the Science of Facial Aging series.

The Recovery Process after Mohs Surgery

Reconstruction surgery is required after any Mohs Surgery procedure. Typically the wounds will take over a year to completely heal after the surgery. 10% per month is a typical rate of healing, with the peak at around 2 months.

How does Aging of the Face Manifest Itself?

The upper, mid, and lower face all age as we go through the decades. Dr. Bryce Cowan explains how symptoms of aging typically manifest over time.

The Advantages of Mohs Micrographic Surgery

Dr. Cowan explains when Mohs Micrographic Surgery is recommended, from a physician perspective. At the same time, he emphasizes the importance and necessity of patients doing their own research.

Markers of Facial Aging

Plastic surgeon Dr. Bryce Cowan explains the two primary processes that affect facial aging simultaneously - volume loss, and malposition.

The Cost of a Fat Grafting Procedure

What is the cost of fat grafting compared to injectable fillers? Plastic surgeon Dr. Bryce Cowan explains that it depends on the timeline, the patient’s age, and what they are looking for. Fat grafting is initially more expensive compared to fillers, but has greater longevity by a wide margin.

Fat Grafting: What is it?

What is fat grafting? Plastic surgeon Dr. Bryce Cowan explains this important rejuvenating options that is used both in restorative surgery (after a trauma) and for cosmetic purposes.

Treatment Options for Facial Aging

Can you reverse the aging process? Dr. Bryce Cowan gives us the truth about aging, cosmetic surgery, and the difference between non-invasive procedures like Botox/fillers vs cosmetic surgery.

Surgical Excision and Histological Analysis in Mohs Surgery

In the third video of the Mohs Surgery series, plastic surgeon Dr. Bryce Cowan explains in further detail the combined process of surgical excision and real-time histological analysis of the excised tissue.

Fat Grafting and Volume Loss of the Face

At what age do we start losing volume in the face, and in what areas? Plastic surgeon Dr. Bryce Cowan explains the process of volume loss with age, and how it affects the overall appearance of the face, and how fat grafting can help combat these changes.

Skin Cancer and Genetics

Patients often ask whether they are likely to have skin cancer if their mother or father had this problem. Being a genetic combination of your parents, what you do inherent is the same skin types.

Preparing for Mohs Surgery

Patients need to take some important steps prior to surgery to maximize the outcome of their procedure. The first step for a patient is to ensure that their surgeon is a qualified Mohs surgeon...

Botox, Injectable Filler, and Cosmetic Surgery to Treat Aging Face

What cosmetic procedures might be useful for a given patient? The two key principles of aging of the face are volume loss and tissue malposition. There are many elements changing simultaneously, so it's very rare that there is an effective singular procedure that can act as a fix all solution.

Reconstruction Surgery After Mohs Surgery

A very common question from patients concerning Mohs Surgery is “Will I need reconstruction surgery?” Dr. Bryce Cowan explains why reconstruction surgery is necessary to optimize the final outcome, and outlines the process and importance of this with some examples.

Debunking Common Misconceptions about Aging Process

What cosmetic procedures might be useful for a given patient? The two key principles of aging of the face are volume loss and tissue malposition. There are many elements changing simultaneously, so it's very rare that there is an effective singular procedure that can act as a fix all solution.

Advantages of Cosmetic Surgery when Treating Aging Face

What are the advantages of cosmetic surgery over soft procedures like Botox and dermal fillers? The main advantage is that cosmetic surgery allows for a more profound and long lasting correction that's not possible with other treatment options.

Expectations vs True Risks of Surgery

What's the difference between true risks and expectations of surgery? Dr. Cowan explains the difference.

Fat Grafting vs Synthetic Fillers

Synthetic fillers like hyaluronic acid are now incredibly popular to restore lost volume, like fat grafting. In this video we will compare the upsides and downsides of each procedure.

How Long Do the Grafted Fats Last?

Typically grafted fats are long lasting. In this video Dr. Bryce Cowan explains how long fat grafts last in typical scenarios. The longevity of the grafted cells are one of the key selling points of this procedure.

Factors that Affect Cure Rate in Mohs Surgery

Mohs micrographic surgery is often used to treat recurrent skin cancers. In this video, we ask Dr. Bryce Cowan whether previous attempts to remove skin cancer can affect the prognosis of Mohs surgery.

Improved Skin Quality with Fat Grafting

Grafted fat is transferred as whole cells which are believed to contain stem cells that release cytokines and growth factors. This promotes a rejuvenative process in the surrounding skin.

The Process of Fat Grafting

We ask plastic surgeon Dr. Bryce Cowan about what patients should expect on the day of the surgical procedure.

What to Expect After a Fat Grafting Procedure

In this video Dr. Bryce Cowan explains what the patient should expect after a fat grafting treatment in terms of results, as well as the side-effects that patients can expect following the procedure.

Risks Associated with Fat Grafting

Plastic surgeon Dr. Bryce Cowan explains the risks associated with the fat grafting procedure that patients should be aware of before undergoing the procedure. Although serious complications are rare, it’s important to be aware of the various potential risks.

Patient Research: How Would Patients Choose Their Surgeon?

Patients need to be able to both understand and accept the risks of surgery. It's a balance between their motivation and desire to undergo surgery and their willingness to accept the risks involved with that procedure.

Unfit Candidates for Cosmetic Surgery

Patients need to be able to both understand and accept the risks of surgery. It's a balance between their motivation and desire to undergo surgery and their willingness to accept the risks involved with that procedure.

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