What Is Mohs Surgery
The board-certified professionals at Suncoast Skin Solutions have been dedicated to providing patients with comprehensive surgical, medical, and cosmetic dermatological care. Our cutting-edge surgical and non-surgical approaches to medical and cosmetic dermatology provide our patients with natural-looking results that require minimal downtime and recovery.
What Is Mohs Surgery And When Is It Recommended
Mohs surgery, also called Mohs micrographic surgery, is a procedure that treats certain skin cancers, which is especially important when you consider that skin cancer is the most commonly diagnosed cancer in the U.S. Every year more skin cancers are diagnosed than all other cancers combined!
The majority of skin cancers are nonmelanoma cases. Basal cell carcinoma is the most common form of skin cancer, and squamous cell carcinoma is the second-most common. Mohs surgery is the top-of-the-line treatment for these common types of skin cancers, with an impressive 99% cure rate for newly diagnosed cancers and a 94% cure rate for recurring skin cancer.
Dermatologists can also use Mohs surgery to.treat some melanomas, a less common but more deadly form of skin cancer.
Prime benefits of Mohs surgery as a treatment for skin cancer are that it does not damage surrounding healthy tissue, and it leaves only a minimal scar. That makes it ideal for cancer growths on highly visible areas such as your nose, eyes, lips, ears, and scalp.
The advantage of Mohs surgery over standard excision surgery, where the doctor cuts away the lesion and some surrounding tissue, is that you leave the center with a clean bill of health. With excision surgery, the tissue is sent to a lab to examine whether its cancerous.
What Training Did Dr Michael Graves Receive In Order To Practice Mohs Surgery
Mohs surgery requires specialized training and experience in skin surgery and laboratory analysis of cancer tissue. During the Mohs surgery procedure, the surgeon performs a detailed microscopic analysis of cancerous tissue in our specialized laboratory on-site at Southwest Dermatology & Vein.
Michael Graves has received advanced fellowship training in Mohs surgery at Scripps Clinic in La Jolla, CA under the direction of Dr. Hugh Greenway, a leader in the field of dermatologic surgery who trained direct under Dr. Frederick Mohs, the inventor of Mohs surgery.
Additionally, Dr. Graves received extensive training in facial reconstruction working directly with top plastic surgeons, head and neck surgeons, and oculoplastic surgeons.
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Benefits And Risks Of Mohs Surgery
Mohs surgery is considered a lower-risk procedure because it is a minimally invasive procedure that can often be performed in an outpatient setting. People who have Mohs surgery do not typically require an overnight stay at the hospital.
Mohs surgery carries a number of benefits for those who receive it. It is extremely effective at curing skin cancers such as BCC and SCC and it leaves the smallest scar possible, limiting the need for .
Mohs Surgery Is Very Precise
During Mohs surgery, a dermatologic surgeon like Maher removes skin from a skin cancer site one stage at a time. First, a dermatologic surgeon outlines the lesion with ink to map the tumor. After a local anesthetic is injected, the doctor removes the thinnest possible layer of cancerous tissue. While the patient waits, that layer is processed in an onsite pathology lab. After processing, the dermatologic surgeon can then examine the entire margin of removed tissue under the microscope to determine whether any cancer remains. If skin cancer persists, the dermatologic surgeon can identify the precise location of the remaining cancerous cells. At that point, the patient returns to the operating room so that the surgeon can take another layerand the process is repeated until all cancerous tissue has been removed. Roughly 80 percent of patients only need a single layer of skin removed in order to remove all the cancerous tissue. This layer-by-layer approach keeps the incision as small as possible to reduce scarring and promote healing.
Because of the way we process these tissue samples, looking at 100 percent of the margin, we can know for certain when weve removed all of the cancer, Maher said.
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What Is The Process Involved In Doing Mohs Surgery
Mohs surgery is unique in its precision. Instead of removing the entire clinically visible tumor and a large area of normal-appearing skin around it, the specialized surgeon removes a minimum amount of healthy tissue to totally remove the cancer. Thin layers of tissue are systematically excised and examined under a microscope for malignant cells. When all areas of tissue are tumor-free, surgery is complete. This process should not be confused with frozen sections, which refers to random sectioning, examining only a small area of the overall specimen.
What Can I Expect Regarding My Wound Healing
Dr. Graves is well versed in advanced wound healing techniques and surgical reconstruction.
The vast majority of Mohs surgical wounds are able to be repaired immediately, and depending on the situation, some may be allowed to heal without surgical repair. In select cases, our surgeons may think it best to refer their patient to a plastic surgeon for reconstruction. All of these options are discussed in detail with each patient so that a joint decision regarding wound healing can be made.
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Community Views: Advice To Someone Having Mohs Surgery
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Mohs surgery is far from an easy procedure. In this surgery, your Mohs surgeon will remove your skin cancer layer by layer and requires multiple steps. Once your surgeon examines the layer removed under a microscope, he or she will determine if there are any cancer cells left. If your surgeon notices any cancer cells, they will remove another layer of skin. This process repeats until there are no more cancer cells present. This procedure is quite extensive and its important to know as much as you can about it.
We asked our : What’s the best advice to give someone that’s having their first Mohs surgery?
Here are some of the things you shared:
Dr Jessica Suzanne Mosher
At DermWellesley, Dr. Jessica Suzanne Mosher, our fellowship-trained, veteran Mohs surgeon and board-certified dermatologist has over 12 years of performing this highly specialized surgery.
Your skin cancer must meet certain criteria in order to qualify for Mohs surgery. Whether or not your cancer qualifies for Mohs will be determined by your dermatologist once the results of your biopsy has returned.
Here is a fantastic video describing the process:
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How Is Mohs Surgery Different Than Other Methods Of Removing Skin Cancer
- Mohs surgery is the most precise method for removing skin cancer and is the gold standard for skin cancer removal, with a cure rate of almost 99% for many lesions.
- Most other skin cancer removal techniques either remove or destroy significant areas of normal tissue around the skin cancer.
- Since the absolute minimum of normal skin is removed during Mohs surgery, it leaves the smallest surgical wound possible.
- The increased size of wounds left with other skin cancer removal techniques means repair can be larger and more complicated.
- Smaller wounds with Mohs surgery allow for less complicated surgical repairs, which makes an excellent cosmetic result more likely.
- Other techniques of skin cancer removal can require a patient to go to a surgery suite and be put under general anesthesia, which has significant risks and complications.
- The Mohs procedure is performed under local anesthesia, meaning substantially increased safety, decreased downtime and minimal complications.
Mohs Surgery Skin Cancer Treatment In Westerville Oh
Do you have a skin cancer that might require Mohs surgery? At the Center for Surgical Dermatology, all of our Mohs surgeons are board-certified and Fellowship-trained members in good standing of the ACMS, which means you receive the best treatment available.
Want to learn more? Give us a call at 847-4100 or contact us online to receive more information regarding Mohs surgery in Westerville, OH, or additional skin cancer treatment options.
Center for Surgical Dermatology is the largest medical and surgical skin treatment and wellness facility in Central Ohio. Since 2007, our board-certified dermatologists, fellowship-trained Mohs surgeons, and caring professional staff have provided patients with treatment they can trust in an environment second to none. Learn more about our state-of-the-art Dermatology Center before booking your appointment today.
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Am I A Candidate For Mohs Surgery
Most Mohs surgeries are performed to treat head and neck cancer, but some skin cancer patients are candidates because the location of their tumor means theres very little extra skin around the tumor site. A smaller excision means less skin is removed, and a less-intensive reconstructive procedure will be required.
A for surgeons and patients alike can help determine whether the location of a tumor makes a person a good candidate for the surgery.
Younger People Benefit Too
The number of people who develop skin cancer has been increasing for decades, and, alarmingly, more women and men under age 40 are now being diagnosed with the disease. Particularly in women, indoor tanning has been linked by many experts to an increased incidence of skin cancers at younger ages.
In my practice, I treat at least one patient in his or her 30s each week with Mohs surgery and many in their 40s and 50s, which is vastly different than 20 years ago, when the majority of patients were older. Not many young people seriously worry about getting skin cancer. Many use tanning beds and skip sun protection, and if they discover an unusual growth on their skin, they often delay seeking treatment because they think its no big deal. But it can be. Basal cell carcinomas rarely metastasize, or spread through the body, but some have aggressive growth patterns and can cause significant damage by growing along nerves or blood vessels, or through muscle or bone. By allowing the cancer to grow, you risk requiring more extensive surgery in the future. Squamous cell carcinomas can be more dangerous, carrying an approximately 4 percent risk of metastasis and 2 percent risk of death6, and the risk increases when these cancers return after treatment.
Arielle N.B. Kauvar, MD
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Why Choose Torrey Pines Dermatology
Dr. Kristen Richards, our Founder and CEO, is one of very few Fellowship-trained Mohs micrographic surgeons here in San Diego. The American College of Mohs Micrographic Surgery and Cutaneous Oncology is the official organization responsible for training Mohs surgeons and maintaining a high standard of care in the specialty of Mohs surgery. To become a member of this organization and to be known as a Mohs surgeon, a special one to two-year fellowship, following a dermatology residency, is required. Only a limited number of dermatologists are trained each year to be Mohs surgeons, in order to maintain the highest level of competence in the specialty.
If your doctor has referred you to Torrey Pines Dermatology to have Mohs micrographic surgery at our La Jolla practice, you will be scheduled for a preoperative consultation. This visit allows Dr. Kristen Richards to examine your skin cancer, obtain your medical history, and determine whether the technique of Mohs micrographic surgery is the most appropriate treatment for you. It also gives you the opportunity to meet Dr. Kristen Richards and her staff and learn about the procedure.
What Is Mohs Skin Cancer Surgery
Home // Blog // Dermatology // What is Mohs Skin Cancer Surgery?
Skin Cancer Care Specialists | November 11, 2016
When you or someone you love has skin cancer, one of the most specialized and effective treatment techniques is Mohs Surgery. First created in the early 1940s by Dr. Frederic Mohs of the University of Wisconsin, Mohs Surgery is a treatment designed to completely remove an occurrence of skin cancer. It works best in situations where the cancer is large, cannot be defined easily, returns after being treated and/or affects a sensitive area where its important to spare as much normal skin as possible. Through its microscopic tumor detection and very selective removal of the area, it offers the highest probability of complete cancer removal while also preserving surrounding tissues.
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What Kind Of Closure Will I Need
The depth and extent of skin cancer is difficult to predict, but the majority of wounds can be closed with a straight line closure.
In more complex areas flaps* or grafts** may be needed.
Some wounds will heal best without any repair.
Every surgical wound is unique, and your doctor will discuss the benefits of each repair option in detail with you. You will have the opportunity to ask any questions you may have before the repair is performed.
*A flap involves using nearby tissue to fill in a defect while minimizing the noticeable deformity.
** A graft involves taking skin from one area and stitching it on another.
What Types Of Skin Cancer Does Mohs Surgery Treat
Most commonly Mohs surgery is used to treat basal cell carcinoma and squamous cell carcinomas. Skin cancers may destroy the skin and structures where they grow and might be fatal if left untreated. However, skin cancers treated with Mohs surgery usually do not spread to other parts of the body.
Skin cancer will not go away on its own and while it may seem to heal over time, if untreated, they always come back bigger, and with deeper roots. While the removal of skin cancer is not an emergency, it should be removed within a month or two of diagnosis. Read more about skin cancer here.
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What To Know Before Surgery
When you meet with Dr. Weisberg in a pre-operative consultation for Mohs Surgery, he will evaluate your medical history, location of your tumor, etc. Before surgery, here are some things to keep in mind:
- Shower/Bathe the Night beforehand. Youll want to wash your hair the night before surgery, as you may need to keep your wound/dressing dry for 48 hours or longer after your procedure.
- Sleep. Get a good nights rest the night before your surgery.
- Eat Breakfast. Go ahead and eat a normal breakfast unless youve been instructed otherwise.
- Take Medications. Whatever normal medications you take, youll likely still take them before your Mohs Surgery. Unless you receive different instructions at your consultation, you can go ahead and keep taking them.
On the day of your surgery, its a good idea to wear comfortable, loose-fitting clothing. If your operative area will be on your face, dont wear makeup.
Why Choose Us For Mohs Surgery
Mohs surgery is a highly sought-after, specialized dermatologic surgery to remove malignant tissue and avoid extensive surgery, wide incisions or skin flaps. The procedure is very technically challenging and requires a high level of skill.
At The University of Kansas Health System, we offer the experience of fellowship-trained, board-certified physicians as part of your care team. In addition, our leading Mohs surgery specialist has completed more than 1,000 successful Mohs procedures.
In certain cases, our health system provides immediate reconstructive surgery in tandem with Mohs surgery to ensure the best cosmetic result. Our streamlined referral process ensures that you have access to the reconstructive surgery experts you need as quickly as possible.
Our is nationally recognized and offers innovative tests and treatments, a comprehensive care model, transplant dermatology and psoriasis treatment, so you can trust you’re receiving the best care available.
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Can Mohs Treat Melanoma
Yes, dermatologists occasionally recommend Mohs for treating melanoma, the most serious type of skin cancer. Mohs is only used to treat an early melanoma, and it must be a type of melanoma called lentigo malignant melanoma. This type of melanoma stays close to the surface of the skin for a while.
When treating melanoma, the surgeon uses a modified type of Mohs surgery called slow Mohs. Its called slow because the patient must wait longer for the results. Its not possible for the surgeon to look at the removed skin and know right away whether it contains cancer cells. More time is needed.
If you have slow Mohs, the surgeon will remove the visible skin cancer and a bit of normal-looking skin around it. Youll then be bandaged and sent home.
Most patients return the next day. Its then that the patient learns whether more skin must be removed or the wound can be closed. Again, some wounds are left to heal on their own.
Does My Insurance Pay For Mohs Surgery
In most cases, your medical insurance will cover Mohs surgery though you will be responsible for any deductible and copayment required by your policy. We like to arrange for your insurance company to reimburse us directly if possible. If paying for your Mohs surgery is a hardship, please let our Skin Cancer & Dermatology Institute team know, and we will work out an alternative payment plan.
Additionally, if you are a Medicare enrollee, you should mention any special supplemental policies to our team when you visit one of our offices. Its also a good idea to bring all health insurance cards and policy numbers with you when you come in for your appointment.
Find out more about insurance information here.
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The Mohs Surgical Procedure
Typically, Mohs surgery is performed as an outpatient procedure in the physicians office. Although the patient is awake during the entire procedure, discomfort is usually minimal and no greater than it would be for more routine skin cancer surgeries. The Mohs surgical procedure is illustrated in the following diagrams:
What Are The Results
A dermatological surgeon is concerned with not only removing the cancer but also minimizing scarring. Mohs offers the best cosmetic results of any skin cancer treatment because the least amount of skin is removed to treat the cancer. Preserving healthy tissues also leads to faster recovery times. Although Mohs is not appropriate for treating all skin cancers, it is the most effective for recurring skin cancers or cancers that have a high risk of recurring.
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