Mohs surgery is the most effective and advanced treatment for skin cancer today. It offers the highest potential for cure – even if the skin cancer has been previously treated by another method.
Originally developed in the 1930s, Mohs micrographic surgery has been refined into the most advanced, precise, and effective treatment for an increasing variety of skin cancer types. With the Mohs technique, physicians can precisely identify and remove an entire tumor while leaving the surrounding healthy tissue intact and unharmed.
The Mohs Procedure involves surgically removing skin cancer and examining it layer by layer, under a microscope to evaluate 100% of the margins. Our Gardens Dermatology dermatologists are board certified in Microscopic Dermatologic (Mohs) Surgery and are trained as a cancer surgeons, pathologists, and reconstructive surgeons, Mohs surgery has the highest success rate of all treatments for skin cancer – with up to a 99% success rate. Below includes before and after photos of one of our Mohs patients:
Advantages of Mohs Surgery
Mohs surgery is unique and so effective because of the way the removed tissue is microscopically examined, evaluating 100% of the surgical margins. The pathologic interpretation of the tissue margins is done on site by the Mohs surgeon, who is specially trained in the reading of these slides and is best able to correlate any microscopic findings with the surgical site on the patient. Advantages of Mohs surgery include:
- Ensuring complete cancer removal during surgery, virtually eliminating the chance of the cancer growing back
- Minimizing the amount of healthy tissue lost - Maximizing the functional and cosmetic outcome resulting from surgery
- Repairing the site of the cancer the same day the cancer is removed, in most cases
- Curing skin cancer when other methods have failed.
Before Your Surgery
Once you have set an appointment for surgery, you receive a detailed list of instructions to follow beforehand. You may be asked to:
- Temporarily stop the use of certain medications, including some over-the-counter pain relievers, supplements, and other medicines
- Stop consuming certain foods or beverages a number of hours before your procedure
- Stop smoking
- Clear a full day for your procedure, because it is difficult to predict how long it may take.
Your Gardens Dermatology board certified Mohs surgeon and his or her team will give you more information about these and other considerations before your surgery, and it's important to follow this advice as closely as you can to ensure a successful outcome. Your Mohs Procedure Surgeons perform Mohs skin cancer surgery as an outpatient procedure in the office, which has an on-site surgical suite and a laboratory for microscopic examination of tissue. Typically, surgery starts early in the morning and is completed the same day, depending on the extent of the tumor and the amount of reconstruction necessary.
You receive local anesthesia around the area of the tumor, so you are awake during the entire procedure. The use of local anesthesia versus general anesthesia provides numerous benefits, including preventing a lengthy recovery and possible side effects from general anesthesia. You are completely numb in the area of the surgery, though, so the procedure is comfortable.
After the area has been numbed, your Gardens Dermatology surgeon removes the visible tumor, along with a thin layer of surrounding tissue. A technician then prepares this tissue and puts it on slides for your surgeon to examine under a microscope. If the surgeon sees evidence of cancer around the outer edges of the removed tissue, he or she takes another layer of tissue from the area where the cancer was detected. This ensures that only cancerous tissue is removed during the procedure, minimizing the loss of healthy tissue. Your surgeon repeats these steps until all samples are free of cancer.
After Your Surgery
When your surgery is complete, your Mohs surgeon assesses the wound and discusses your options for ideal functional and cosmetic reconstruction. Your surgeons understand that a good cosmetic result is an important part of the recovery process, and that's why they work so hard to leave as little tissue damage as possible. If reconstruction is necessary, the Mohs surgeon usually repairs the area the same day as the tumor removal.
Post-Operative Care: After a Mohs surgery procedure, most patients find the recovery process simple and easy thanks to the streamlined surgical approach that leaves surrounding tissue unharmed. Nonetheless, it's common for patients to wonder what they can expect after a Mohs skin cancer surgery. It's also important to use the post-operative period to plan an ongoing skin cancer detection strategy for the future.
The surgeon and his or her medical team will provide you with detailed instructions to follow at home, and it's important you do so in order to enhance your healing and final outcome. These instructions will include:
Information about when to change bandages and how to clean the surgical site Medication information about prescription or over-the-counter pills or a schedule of follow-up appointments to remove any stitches and monitor your healing.
Recommendations for treating your Mohs surgery scar to ensure it heals and fades quickly because our dermatologists perform the procedure in an outpatient setting using only local anesthesia, immediate recovery generally involves little more than resting and simple wound care. Some patients may experience mild discomfort, bleeding, redness, or inflammation, but these are typically temporary and easily manageable.