Mohs Surgery is a highly specialized, state of the art treatment for skin cancer. It is named after Frederic Mohs, M.D., who developed the technique. This procedure is performed in an outpatient setting, under local anesthesia. The method differs from other treatments of skin cancers by combining the surgical removal of the area with precise microscopic analysis to ensure that all of the cancer is removed without taking additional, normal skin. This technique has the highest cure rate, 99%, of any procedure used in the treatment of skin cancer. It is the most exact and precise method to treat skin cancers at this time.
By using detailed mapping techniques through microscopic examination, the ‘roots’ of the skin cancer are removed in a precise and accurate fashion. The Mohs surgeon can detect involvement by cancerous cells that are not visible to the naked eye, which allows for removal of ONLY the diseased skin. This results in:
A 99% Cure Rate – the highest of any technique used to treat skin cancers
The lowest chance or recurrence or regrowth
The smallest wound or defect possible, minimizing the cosmetic impact
What Happens On
The Day Of Surgery?
Your appointment will usually be scheduled first thing in the morning, between 8 and 8:30 AM. A Nurse will take a medical history, review a consent form and take your blood pressure. The area will be ‘numbed’ with local anesthetic, which acts immediately and keeps the area numb for several hours. A thin layer around the affected area is removed and a bandage placed over the site. The specimen is taken to the lab where it is processed and stained, and microscopic slides are prepared, which takes approximately 40-45 minutes.
During this time you will be asked to wait in the patient waiting area. You may want to take a book or work material with you. Magazines and beverages are available for you during this time. You are asked NOT to leave the office during the waiting period.
Anywhere from one to three stages are usually required to completely remove the skin cancer, although occasionally more are necessary. Since each stage requires 45 minutes or so to prepare, it make take several hours to complete the procedure. Therefore, we ask you make no other commitments that morning.
Will the surgery leave a scar?
Yes. Any form of treatment for skin cancer leaves a wound and scar. However, because the Mohs procedure removes as little normal, uninvolved tissue as possible, the resulting defect size is minimized. Immediately after the skin cancer is removed entirely, the decision is made how the wound should be taken care of. The options are:
1) to repair the wound edges with stitches
2) to reconstruct the area using a flap or graft from adjacent skin
3) to allow the area to heal itself, or
4) if the defect is particularly large or in a very sensitive area such as the eyelid margin, refer you to a plastic or oculoplastic surgeon for reconstruction of the site. Usually, this is discussed with you and arranged in advance.
Sutures are usually removed one week (seven days) after the surgical procedure. You must be available to return to the office for suture removal.
Will I have pain after the procedure?
The anesthetics generally used last from two to four hours. Tylenol, Advil, Aleve, Ibuprofen or other over the counter pain relievers are usually all that are necessary afterwards. However, Darvocet (a mild prescription pain reliever) or other agents will be prescribed for your use if necessary.
Will my insurance cover the cost of the surgery?
We do accept assignment on Medicare claims and will file most insurance policies for you. In addition, our staff will preauthorize the procedure, if necessary. Co-pays and deductibles, however, are expected on the day of surgery.