Mohs MICROGRAPHIC SURGERY PRESERVES HEALTHY TISSUE

Mohs MICROGRAPHIC SURGERY PRESERVES HEALTHY TISSUE

If you have basal cell carcinoma or squamous cell carcinoma, we may recommend removing your cancer with Mohs Micrographic Surgery. Dr. Frederic Mohs of Madison, Wisconsin, developed this highly specialized technique more than 70 years ago to remove skin cancer while preserving healthy tissue.

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 has these critical components:

  • Remove the layer of skin cancer
  • Review the specimen under the microscope
  • Repeat removal and examination as many times as needed
  • Reconstruct the defect

Dermatology specialists prefer this technique when the tumor is large, recurrence is likely, or 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 re-growth
  • Minimizes the potential for scarring or disfigurement
  • Is the most exact and precise means of removal

Mohs Surgery ProcessHOW IS MOHS SURGERY PERFORMED?

To 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.

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.

HOW IS THE WOUND RECONSTRUCTED?

Once we remove the cancer, we determine the best plan for wound reconstruction and closure. The type of repair depends of 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 usually repair wounds the same day as the surgery. Rarely, a staged repair requiring a series of procedures over weeks or months may be required. In almost all cases, we can preform a repair in our office. We’ll refer exceptions to a specialist.

HOW SHOULD I PREPARE FOR MOHS MICROGRAPHIC SURGERY?

For optimal healing after Mohs Micrographic Surgery and facial reconstructive surgery, please do the following:

BEFORE SURGERY:

  • 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

FOLLOWING YOUR SURGERY:

  • Avoid excessive lifting and physical activity
  • Follow your post-operative instructions
  • If unsure about your wound care, please ask
  • Attend your follow-up appointments as scheduled

WHAT’S IMPORTANT TO REMEMBER?

  • 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.
  • Arrive 15 minutes prior to your appointment to allow time to complete medical forms.
  • Arrange to have a companion drive you to and from the doctor’s office. We do ask that you bring no more than one person with you, as seating is limited.
  • We provide magazines, bottled water, and snacks.

DO I NEED ANTIBIOTICS PRIOR TO MOHS SURGERY?

Not usually. However, we recommend antibiotics 30 to 60 minutes prior to your surgery if any of these circumstances apply:

  • Joint replacement surgery within the past year
  • An artificial heart or heart valves
  • History of endocarditis/infected heart valves
  • Severe dysfunction of a heart valve

If these situations apply, we can prescribe an appropriate antibiotic. Please call the office at least two to three days before your appointment to request a prescription.

WILL THERE BE MUCH PAIN?

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 provides adequate pain control. Applying ice packs over the bandage at the surgical site can reduce pain, swelling, and bruising.

HOW DO I TAKE CARE OF THE WOUND AFTER MOHS SURGERY?

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 with dilute peroxide and petroleum jelly and a bandage will 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 suture removal in 7-14 days.

HOW DO I SCHEDULE MOHS MICROGRAPHIC SURGERY?

If you have a skin cancer and are interested in the surgery, please call us at 901.624.3333 to schedule your consultation.