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What is Mohs micrographic surgery?

Mohs micrographic surgery is a microscopic surgical procedure, named after its inventor, Dr. Frederic Mohs, that is used to remove skin cancer. Thin layers of skin are surgically removed and processed by horizontal sectioning. If cancer is detected within the tissue margins, the cancer is then mapped and another layer or stage is taken. The process is repeated until there is no cancer within the tissue margins.

Is Mohs a good treatment for skin cancer?

Numerous studies have shown that Mohs is simply the best way to check a surgical margin to ensure the cancer is completely removed so there is less chance of any cancer recurrence. In these studies, Mohs had the highest cure rate for skin cancer removal and was shown to be most useful in removing recurrent skin cancers.

There are several aspects of the Mohs procedure that make it both unique and superior to other methods of treating skin cancer.

  • Highest cure rate among skin cancer treatment modalities.
  • Reduces errors that can occur with other skin cancer treatments.
  • Increases accuracy of skin cancer removal and immediate results.
  • Decreases the amount of healthy tissue removed, and minimizes surgical risks and scarring.
  • Performed under local anesthetic.
  • Can be less expensive than other treatments.
  • Can result in quicker recovery.

What are possible complications of Mohs?

As with any surgery or procedure, Mohs surgery has some possible risks and complications. However, they are generally outweighed by the benefits. Common risks of Mohs surgery include but are not limited to swelling and bruising. Scarring will always occur with any surgery and a wound will sometimes be slow to heal. Numbness and tingling can be present for weeks to months but will usually resolve. Some uncommon risks include excessive bleeding, infection, paralysis and pain. Mohs can minimize both these surgical risks and scarring because Mohs keeps the wound as small as possible by removing very little healthy tissue. Overall, it’s a very safe and effective surgical treatment for skin cancer.

What is reconstruction? Will I have a scar?

Mohs surgery will create a wound when the cancer is removed. The more cancer there is, the wider or deeper the wound will be. Reconstruction entails closing the wound after the cancer is surgically removed by Mohs. The type of reconstruction will depend on if the wound is small or large, and if the wound is in an optimal location or difficult location. Retention of form and function are also considerations in the type of reconstruction options available. The options for reconstruction include the wound being left to heal on its own, being sutured in a simple fashion or being repaired with a flap or graft. Reconstructions may be performed by Dr. Hendrix or may require being seen by a plastic surgeon.

What areas are treatable by Mohs surgery?

Mohs surgery is used to treat skin cancers primarily on the face where there is not a lot of extra skin to spare and where scars can be more noticeable. Studies have shown that Mohs is the best option for treatment of skin cancer on the nose, eyelid, lip, and ear. The Mohs surgical procedure is also highly recommended for cancers that are likely to recur, have recurred or have ill-defined borders that make the true extent of the cancer hard for the surgeon to see.

What kind of physician can perform Mohs surgery?

Most Mohs surgeons are board certified dermatologists who have undergone a formal post-residency fellowship training in Mohs surgery at a major university hospital for one to two years. Please ensure that your Mohs surgeon has participated in a quality fellowship and is also a member of the American College of Mohs Surgery.

How long does Mohs surgery take?

Mohs surgery is usually performed in the doctor’s office under local anesthetic. You are generally in the office for several hours starting in the morning on the day of your Mohs procedure. The time it takes really depends on how much cancer is present and where the cancer is located. It can be hard to predict how many layers will be removed. You should plan to spend the entire day at the doctor’s office on the day you have Mohs scheduled.

Is Mohs surgery the right treatment for me?

The decision to undergo Mohs surgery can only be determined by you and your doctor.

Are there any health issues that could be complicated by Mohs?

Inform your physician of any medications you take, as well as infections, heart conditions or reactions to different types of drugs you may have. While Mohs is an excellent way to treat skin cancer, it’s critical that you make your doctor aware of any current medical conditions and your medical history. With this information, you and your doctor will be able to make an informed decision.

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