Mohs Micrographic Surgery

What is Mohs micrographic surgery?

Mohs surgery, the gold standard for skin cancer surgery, is a precise method to remove a cancerous growth in tiny increments. This approach allows surgeons to examine 100% of the tumor margin but excise only the cancerous cells. 

Ultimately, Mohs surgery offers a 98-99% cure rate for new cancers and a 95% cure rate for recurring cancers while sparing the maximum amount of healthy tissue. 

Our Mohs surgeons are fellowship-trained physicians who have completed additional specialized training in removing and repairing large and complex tumors. Thomas Dermatology takes great pride in hiring some of the most skilled Mohs surgeons in the country. 

How does Mohs micrographic surgery work?

You may receive local anesthesia for your Mohs procedure, so you can be awake throughout the process. Your surgeon removes the visible portion of the lesion as well as a very small amount of the tissue around it. 

You wait as your surgeon examines the lesion in the on-site pathology lab. They create a map to mark the locations of any cancerous cells (besides the lesion) that they find. Then, they follow this map to excise an additional layer of tissue from only the cancerous areas. 

They return to the lab to examine and map that layer of tissue and then continue this process in stages until there's no cancer left. 

After removing the entire cancerous lesion, your Thomas Dermatology surgeon performs wound repair or reconstruction as needed. Depending on the size and depth of the area, they may do a simple closure, skin flap, or skin graft.

For relatively small surgical sites, they may leave the wound to heal itself. For complex or more significant reconstruction, a plastic surgeon may assist.

Am I a candidate for Mohs micrographic surgery?

The best candidates for Mohs surgery are usually people with one of two types of skin cancer: basal or squamous cell carcinoma. Mohs surgery is particularly well-suited for people with tumors in delicate areas such as:

• Nose
• Ears
• Eyelids
• Lips
• Hairline

You may also be a good candidate for Mohs surgery if you have skin cancer in an area where preserving the maximum amount of healthy tissue is especially vital, such as the hands, feet, or genital organs.

The Thomas Dermatology team may also recommend Mohs surgery if you have recurring skin cancers.

What should I do before Mohs micrographic surgery?

The Thomas Dermatology team gives you specific directions ahead of your Mohs surgery. Bring an up-to-date list of medications to your pre-surgery appointment. 

If you take warfarin, the team needs to know your most recent prothrombin time (PT) and international normalized ratio (INR) results. 

If you use any herbal supplements, the team may recommend discontinuing those that increase the risk of bleeding at least a week ahead of your Mohs surgery.

Because your surgery day may be a long one, be sure to get plenty of rest. Bring a healthy snack along with a digital device, book, or other means of entertainment to pass the time during staging. 

What should I do after Mohs micrographic surgery?

Below is a very helpful video from the American College of Mohs Surgery outlining the healing process and tips on making your recovery as smooth as possible.

If you are concerned that you might have skin cancer schedule your next full body checkup appointment at Thomas Dermatology by calling the nearest office or booking online.