Understanding Mohs Surgery

Doctor examining a tissue slide under a microscope during Mohs surgery

Understanding Mohs Surgery

Did you know that skin cancer is the most frequently diagnosed cancer in the United States, but that it’s also one of the most preventable? The three most common types of skin cancer are squamous cell carcinoma, basal cell carcinoma, and melanoma. In this article, we’ll describe a typical Mohs surgery at Brentwood Dermatology, explain the benefits, and share some easy tips to help prevent skin cancer.

What is Mohs surgery?

Mohs surgery is a skin cancer treatment that removes cancerous tissue one layer at a time. A Mohs surgeon will take each layer of tissue to an on-site lab and examine it for cancerous cells. If any remain, the surgeon will map them out and remove a little more tissue in only the locations indicated on the map, thereby preserving the surrounding healthy cells.

The surgery often takes multiple rounds of tissue removal to get all of the cancerous cells, but it has the highest cure rate of any skin cancer surgery and the most minimal scarring. According to the Skin Cancer Foundation, Mohs surgery has a 99% cure rate for skin cancer that has not been treated before and a 94% cure rate for cancer that has come back after previous treatment.

Frederic E. Mohs, MD, invented Mohs surgery in the late 1930s. He spent decades refining his method and founded the American College of Mohs Surgery (ACMS) in 1967 to train other doctors in the precise surgery. Modern Mohs surgeons perform three primary functions: surgery to remove cancerous tissue, pathology to analyze each tissue specimen, and reconstructive surgery to close and rebuild the wound.

Benefits of Mohs surgery

Mohs surgery has several benefits for patients:

  • Highest cure rate of all skin cancer surgeries
  • Lower cost than hospital or outpatient facility surgeries
  • Maximum healthy skin preservation for minimal scarring
  • Reconstruction done in office, when necessary
  • Well-tolerated by most patients
  • Local anesthesia rather than general
  • Suitable for the majority of skin cancer locations
  • Easier aftercare than hospital surgeries

What to expect on your treatment day

If your dermatologist determines that Mohs surgery is the best way to treat your skin cancer, you should be prepared to spend about half of a day in the office, possibly longer. A patient’s day will begin by reviewing the diagnostic biopsy results with the surgeon, discussing the procedure, and answering questions.

The Mohs surgeon will provide local anesthesia, clean the surgery site, and take the first Mohs layer. Then, the surgeon will bandage the site and take the tissue to the lab to examine. It takes about an hour to remove and examine each layer of tissue.

In the lab, the Mohs surgeon will work with a lab tech to prepare tissue slides and examine them. The surgeon will note any remaining cancer cells on a map, which will guide his or her next round of targeted tissue removal. The surgeon will repeat this as many times as necessary until there is no cancer left.

Once the surgeon has removed every cancer cell, he or she will close the patient’s wound site. If the area is small, it may only take a few stitches to close. Other times, the Mohs surgeon will need to perform a skin graft to repair the wound. In rare cases, such as when the cancer is especially aggressive or deep, a patient may need to see a separate reconstructive physician.

Mohs surgery aftercare

For most people, recovering from Mohs surgery is a breeze. Your surgeon will apply a pressure dressing that you should leave on for 24 – 48 hours and keep dry. Then, keep the site clean with gentle soap and warm water and cover it with a band-aid or gauze until the surgeon removes the stitches.

Your dermatologist will monitor you for recurrence or new cancers for 3 – 6 months after surgery, although the rate of recurrence at that site is only 1 – 2% after Mohs surgery.

Skin Cancer Prevention

While Mohs surgery is the best method for removing skin cancer, we prefer to help patients avoid skin cancer instead of performing surgery. Whether you’ve had squamous or basal cells removed in the past or not, you should take steps to protect your skin. Our top three ways to prevent skin cancer are:

  • Wear sunscreen every day, even if you’re inside – sun shining through the windows can still damage your skin.
  • Avoid sun exposure from 11 AM – 3 PM when the sun’s rays are the strongest.
  • Wear protective UPF clothing such as hats, long sleeve shirts, and pants if you’re spending time outdoors.

 

Just a few simple precautions can drastically reduce your risk of developing skin cancer.

Mohs surgery at Brentwood Dermatology

Brentwood Dermatology is proud to provide Mohs surgery for our patients. Our dermatologists have extensive training in surgery, pathology, and reconstruction to provide the best surgical and cosmetic outcomes for our patients.

If you have a spot that you suspect may be skin cancer, schedule an appointment at Brentwood Dermatology today.

 

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