Mohs surgery

The Mohs procedure is the most advanced and precise surgery for the removal of skin cancer. It allows our surgeons to remove cancerous tissue one layer at a time, microscopically examine it, and perform reconstructive surgery if needed, all within the same day. The precision available by this outpatient procedure not only minimizes the loss of healthy tissue, making it especially effective in cosmetically sensitive areas like the face, but also allows patients to have a short recovery period.

The Mohs surgeon removes the visible tumor along with a thin layer of surrounding tissue. An experienced technician prepares the tissue and places the tissue on slides, for the surgeon to examine it. If the surgeon finds evidence of cancer, another layer of tissue is taken and examined. These steps are repeated until all tissue samples are cancer free.

Even if your skin has been previously treated by another method, Mohs surgery allows our surgeons to:

  • Remove cancerous tissue one layer at a time
  • Microscopically examine the tissue
  • Perform reconstructive surgery if needed
  • Minimize the loss of healthy tissue through precision

Mohs surgery allows patients to have a short recovery period Surgeries and closures can be done in one visit on the same day, allowing for immediate reconstruction of the wound. Mohs micrographic surgery is also ideal for the removal of recurrent skin cancers (tumors that reappear after treatment) and can plague a patient repeatedly. While skin cancers are easily visible to the patient, individual cancer cells are microscopic and any cells left behind can cause the tumor to reappear. The tumor may spread beyond its obvious external margins, with nests of cells growing in unpredictable areas. With the Mohs technique, all tumor nests can be identified and removed with a high degree of accuracy, so that extremely high cure rates, as high as 95 percent, are possible even when the cancer is recurrent.

A dermatologist is best trained to determine when this technique should be used rather than the other effective procedures also available for treating skin cancer

What is Mohs Micrographic Surgery?

Mohs micrographic surgery is named in honor of the physician who developed the basic technique, Dr. Frederic Mohs. You may hear it called Mohs surgery, chemosurgery, microscopically controlled surgery or histographic surgery—it’s all the same. In the years since Dr. Mohs pioneered the procedure, many technical improvements and refinements have contributed to make micrographic surgery a safe and highly effective means of treating skin malignancies.

The main difference between micrographic surgery and other methods of removing skin lesions is microscopic control. In Mohs surgery multiple thin, horizontal layers of the cancer are removed. The surgical removal proceeds along a grid pattern, with each layer carefully identified and mapped by the surgeon so that its exact location can be pinpointed on the wound.

Every layer of tissue removed is inspected under the microscope for evidence of cancer cells. As long as cancer cells are seen anywhere within the specimen, the surgeon continues to remove and examine tissue layers from that section of the wound until none are present. Because each layer is examined microscopically, dermatologists can be reasonably certain that all the cancer has been eradicated and that no tumor nests are left behind. In addition, only the cancerous tissue is removed, saving as much normal skin as possible.

What to expect before and after Mohs surgery?

Mohs micrographic surgery is commonly performed on an outpatient basis with a local anesthetic administered to the area around the tumor. Surgery usually begins early in the morning and is finished the same day unless the tumor is extensive.

Because of the layer-by-layer removal, laboratory preparation and examination under the microscope are delicate and require great precision. They are also time consuming. If more than one session is needed to remove all signs of tumor, a dressing is applied. Once the area is declared cancer-free, your surgeon will discuss the options of wound healing or reconstructive surgery.

Periodic visits to your dermatologist are recommended to check on your progress and spot any possible cancer recurrence as soon as possible. One in five patients with one skin cancer will develop another within five years, so follow-up is extremely important for early detection of any new lesions.

Rationale for Mohs Micrographic Surgery

Cure rates for skin cancer after treatment with Mohs micrographic surgery are as high as 95 percent. The technique produces the smallest possible wound in the removal of any given tumor. The smaller the wound, the greater the chances for a good cosmetic result after the wound has completely healed. This is particularly important on the face, where a good appearance after surgery is of concern to the patient.

An overwhelming majority of tumors can be totally removed in one treatment session, due to the preciseness of the surgery and microscopic inspection

Skin surgery

Skin surgery is an office procedure performed for both medically necessary and cosmetic indications to maintain the health, function and appearance of your skin. Skin surgery is used to remove skin cancers (such as Mohs micrographic surgery—link to Mohs page), moles, cysts, lipomas, and benign lesions such as skin tags and seborrhea keratoses. Office based skin surgery usually involves injection of local anesthesia prior to the procedure to assure patient comfort.

Skin cancer education

The same type of skin cancer can look very different from person to person. This makes it hard to look at a picture and tell if you have skin cancer. The best way to tell if you have skin cancer is to see a dermatologist. You should see a dermatologist right away for a skin cancer check if you see anything on your skin that lasts for 2 weeks or longer and is:

  • Growing
  • Changing shape
  • Bleeding or itching

These are signs of skin cancer. If it is caught early and removed, skin cancer has a high cure rate.

The most common cancer in the world.

More than 2 million cases of skin cancer will be diagnosed this year. And that’s just in the United States. Most Americans will have one of these skin cancers:
Basal cell carcinoma

Squamous cell carcinoma
Melanoma

If you suspect you have skin cancer, don’t wait.
Call our office: (831) 293-8458

BASAL CELL CARCINOMA

Basal cell carcinoma (BCC) is the most common form of skin cancer. More than two million cases of this skin cancer are diagnosed in the United States each year.

This skin cancer usually develops on skin that gets sun exposure, such as on the head, neck, and back of the hands. BCC is especially common on the face, often forming on the nose. It is possible to get BCC on any part of the body, including the trunk, legs, and arms. People who use tanning beds have a much higher risk of getting BCC. They also tend to get BCC earlier in life.

This type of skin cancer grows slowly. It rarely spreads to other parts of the body. Treatment is important because BCC can grow wide and deep, destroying skin tissue and bone.

SQUAMOUS CELL CARCINOMA

Squamous cell carcinoma (SCC) is a common skin cancer in humans. About 700,000 new cases of this skin cancer are diagnosed in the United States each year.

This skin cancer tends to develop on skin that has been exposed to the sun for years. It is most frequently seen on sun-exposed areas, such as the head, neck, and back of the hands. Women frequently get SCC on their lower legs. It is possible to get SCC on any part of the body, including the inside of the mouth, lips, and genitals.

People who use tanning beds have a much higher risk of getting SCC. They also tend to get SCC earlier in life. SCC can spread to other parts of the body. With early diagnosis and treatment, SCC is highly curable.

MELANOMA

Melanoma is a type of skin cancer. Anyone can get melanoma. When found early and treated, the cure rate is very high.
Allowed to grow, melanoma can spread to other parts of the body.
Melanoma can spread quickly.
When melanoma spreads, it can be deadly.
Dermatologists believe that the number of deaths from melanoma would be much lower if people:

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  • Knew the warning signs of melanoma.
  • Learned how to examine their skin for signs of skin cancer.
  • Took the time to examine their skin.

It’s important to take time to look at the moles on your skin because this is a good way to find melanoma early. When checking your skin, you should look for the ABCDEs of melanoma.

Signs of melanoma

The most common early signs (what you see) of melanoma are:

  • Growing mole on your skin.
  • Unusual looking mole on your skin or a mole that does not look like any other mole on your skin (the ugly duckling).
  • Non-uniform mole (has an odd shape, uneven or uncertain border, different colors).
    If you see a mole or new spot on your skin that has any of the ABCDEs, immediately make an appointment to see a dermatologist.

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