More than 1.2 million people in the United States are diagnosed with skin cancer each year. If left untreated, skin cancer can continue to progress and can be potentially life-threatening and disfiguring.
Mohs surgery is a unique form of surgery that was developed over fifty years ago by Frederick Mohs MD, a professor of surgery at the University of Wisconsin. Since that time the technique has been refined and advanced so that for certain types of skin cancer it offers a cure rate of approximately 98-99.9%.
Mohs surgery is done on an outpatient basis. Local anesthesia is used to numb all feeling in the area around the skin cancer. Once the area is numb, as much of the skin cancer as possible is removed by scraping it with a special instrument. Then a thin layer of skin is removed from the tumor site. At this point a pressure bandage is placed over your surgical wound and you will be instructed to wait in the waiting room. While you are waiting the layer of skin is marked, frozen and stained and then examined under a microscope. It takes approximately 30-60 minutes for the slides to be prepared and studied. If skin cancer is found at the edges of the specimen the Mohs surgeon will repeat the process of removing another layer of skin, preparing it and examining it under the microscope. These steps (also known as "stages") are repeated until all of the skin cancer has been removed. Depending on the extent of the skin cancer, there may be several stages of surgery. The doctor cannot determine ahead of time how many stages of surgery you will require. Assume that you will be in our office for the day, but we will try our best to complete the procedure in a timely fashion.
The major advantage of this technique is that by using a microscope to guide the surgery, the doctor removes only tissue that the skin cancer has already invaded, sparing as much of the surrounding healthy skin as possible. This is especially important if the cancer is on the face. Of course any procedure will leave a scar, but by preserving the maximum amount of healthy skin the mohs surgeon hopes to achieve the best cosmetic result. In addition, this technique gives the highest cure rate possible. The day you leave our office, you will know that cancer is cured to a 98-99.9% certainty and that you scar is the smallest possible because only cancerous tissue was removed.
The mohs surgeon cannot always know ahead of time the extent of the skin cancer, therefore it is difficult to discuss the repair of the skin until the surgery is completed. There are several ways of repairing the skin: 1) allowing the skin to heal by itself, 2) stitching the wound closed, 3) covering the wound with a flap or graft made of healthy skin taken from elsewhere on the body. The doctor will discuss the best options for repair with you.
Please do not hesitate to ask additional questions at your appointment. We will glad to help you in any way we can.
Click here for additional information and a print out on our Mohs surgery, our Mohs surgeon Dr. Todd Coven, as well as pre-operative and post-operative care instructions