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Mohs' Micrographic Surgery for Skin Cancer

Introduction: Approximately 40 years ago, Dr. Frederic Mohs developed a technique known as chemosurgery to remove skin cancers completely while preserving as much normal tissue as possible. This method requires specialized training and personnel. Mohs surgery is a highly successful method of treatment for skin cancer, resulting in the highest cure rates.

Some of your questions about Mohs surgery are answered below. Should you have further questions, please do not hesitate to contact us at any time.

What is Mohs surgery?

It is a specialized procedure for the total removal of skin cancers. It involves removal of small tissue sections and immediate microscopic examination of each to assure complete tumor removal while preserving as much normal tissue as possible.

Click here to view a Power Point Presentation on Mohs micrographic surgery

When to schedule surgery?

Depending on the part of the body affected, and especially if the face is involved, you may be instructed after surgery to avoid bending, stooping, and lifting for up to 48 hours following the procedure. You may also be told to apply ice packs intermittently for 24 to 48 hours. The doctor may prescribe medications that could affect your ability to drive. For these reasons, it is important to schedule your surgery for a time when you will be able to keep your activities light and to rest frequently for the first day or two.

What happens at the first (consultation) visit?

This is an opportunity to examine your skin cancer, take a pertinent history and determine whether the technique of Mohs' surgery is the most suitable way of treating your skin cancer. Also, it gives you an opportunity to ask any questions you may have.

About our staff

The Mohs surgery teams consists of several individuals who will care for you.  All of our physicians performing Mohs surgery completed an additional fellowship year of training mastering this technique and are active members of the American College of Mohs Micrographic Surgery and Cutaneous Oncology.  In addition to the physician, the team includes nurses who are experienced in dealing with patients who have skin cancer and are knowledgeable about possible problems which may arise, and technicians who quickly and skillfully prepare the tissue for microscopic examination. 

What to expect on your day of surgery

First, you should eat before surgery.  Mohs' surgery is performed under local anesthesia, so you do not have to fast prior to surgery.  After checking in with our receptionist, your nurse will bring you back to the operating room.  Paperwork will be completed, your blood pressure and pulse will be measured and recorded, and you will be asked to change into a gown if necessary.  Photographs are taken of your skin cancer both before and after surgery.  Your physician will then come into the room to talk with you prior to surgery.  Next, the skin cancer lesion is anesthetized with local anesthesia, and surgery begins.  Your surgeon will take the narrowest margin possible around the skin cancer.  Our goal is to clear the skin cancer while taking the least amount of normal skin possible.  After the layer is taken, a bandage will be placed on the skin.  Your nurse will then escort you back to the waiting room.  It typically takes about 60-90 minutes to process your tissue.  After your surgeon examines your tissue under the microscope, you will be brought back to the operating room.  If there is still skin cancer present, your surgeon will repeat the above technique until all the margins are clear.  Once the skin cancer is completely removed, you and your surgeon will discuss the best way to repair the defect.  It is reasonable to expect to spend at least half a day if not a full day at our clinic as we work toward completely removing your skin cancer.  You may bring snacks to eat as well as books, cards, etc. to entertain yourself while you wait between layers. 

Aftercare for your surgical site

Your surgeon will review with you appropriate wound care after surgery.  Typically, you will return to our clinic 7-14 days after surgery for suture removal.  Our clinic staff is always available by telephone for questions.