What is Mohs Micrographic Surgery?
With this technique, we remove the cancer one layer at a time and examine the tissue while you wait to make sure the entire cancer has been removed. By working with one layer at a time, we can remove the entire cancer while preserving as much healthy tissue as possible.
Mohs Micrographic Surgery involves these critical components:
- Removal of the layer of skin cancer
- Review the specimen under the microscope
- Repeat removal and examination as many times as needed
- Reconstruction of the defect
Dermatology specialists prefer this technique when the tumor is located on the head and neck or other sensitive areas such as the hands and feet, large cancers, for cancers that have come back after prior removal, or when the type of skin cancer is aggressive. Of all treatment options for skin cancer, Mohs Micrographic Surgery:
- Offers the highest cure rate (up to 99%)
- Has the lowest chance of regrowth
- Minimizes the potential for scarring or disfigurement
- Is the most exact and precise means of removal
To optimally perform Mohs Micrographic Surgery, a dermatologist must be formally trained in a one or two year program and accredited by the American College of Mohs Surgery (ACMS). Feel free to ask our specialists about formal training and their membership status with the ACMS.
Learn More About Mohs Micrographic Surgery
Am I A Good Candidate?
You may be a candidate for Mohs Micrographic Surgery if you have been diagnosed with nonmelanoma skin cancer such as basal cell carcinoma or squamous cell carcinoma, if your skin cancer is recurring and other methods have not effectively stopped it, or it’s located in a spot with thin tissues around it, such as the ear, foot, or nose.
If your skin cancer is aggressive, Mohs surgery may also be your best treatment option. A Levy Dermatologist can determine if Mohs is your treatment of choice during a consultation.
How Does Mohs Surgery Work?
At Levy Dermatology, we perform this surgery on an outpatient basis and under local anesthesia. We numb the area and remove the visible tumor. After this, we remove a thin layer of skin with a scalpel. We examine the tissue under a microscope. If we see cancer cells, we remove another layer of skin. We continue this process until cancer cells are no longer present.
Once we remove the cancer, we determine the best plan for wound reconstruction and closure. The type of repair depends on the shape, size, depth, and location of the wound. Sometimes we can close the defect with sutures. Sometimes a skin flap or skin graft may be necessary.
We often repair wounds the same day as the surgery. Other times the repair is delayed. Rarely, a staged repair requiring a series of procedures over weeks or months may be required. In almost all cases, we perform the repair in our office operatory.
- With this procedure, it is impossible to anticipate how much time is required. To reduce stress, clear your calendar for the day and plan to spend it with us.
- Bring reading material or personal devices to occupy your time while waiting for the microscopic slides to be processed and examined.
How Do I Prepare For Mohs Surgery?
For optimal healing after Mohs Micrographic Surgery and facial reconstructive surgery, please do the following:
- Quit smoking. Tobacco use impairs healing and can result in more severe scarring.
- Avoid blood-thinning medication and supplements — aspirin, ibuprofen, vitamin E, and fish oil — unless a physician specifically prescribed them for you.
- Take any prescribed antibiotics as instructed.
- Refrain from drinking alcohol three days prior to and three days after your appointment. Alcohol increases your risk of bleeding.
The Day of Your Surgery
- Eat your normal breakfast on the day of surgery
What Is Recovery Like?
During your treatment, a local anesthesia (lidocaine) will block pain. There will be some pain associated with the initial injection. You should expect mild-to-moderate pain beginning several hours after surgery, which usually resolves over 24-48 hours. For most patients, acetaminophen, ibuprofen, or naproxen provides adequate pain control. Applying ice packs over the bandage at the surgical site can reduce pain, swelling, and bruising but are usually not necessary.
Wound care varies depending on the type of closure and will be thoroughly explained to you after surgery. In most cases, minimal wound care will be needed as the wound will be covered with a sterile dressing that lasts until the time of suture removal. In other cases, daily dressing changes may be recommended. Depending on the location of your skin cancer and whether or not sutures are placed on the skin surface, you can expect to return for follow up in 7-14 days at which time sutures will be removed and/or the wound reassessed.
To learn more about Mohs Surgery, call one of our convenient locations at (901) 624-3333.