WHAT IS MOHS MICROGRAPHIC SURGERY?
Mohs surgery is a highly specialized form of skin cancer surgery. Most skin cancers extend under the skin beyond what is seen on the surface. Therefore, Mohs surgery has two stages: first all the visible tumor is removed, then while the patient waits, the tissue is processed and carefully examined under the microscope. If there is any cancer remaining, another thin margin of skin is removed, from the affected area only, and this is again examined. The whole process is repeated until all the cancer has been removed.
WHAT ARE THE ADVANTAGES OF MOHS SURGERY?
Mohs surgery has two main advantages over other skin cancer treatments. First, for most skin cancers Mohs surgery offers the highest cure rate possible, approximately 99%. Second, as Mohs surgery is guided by what is found under the microscope, it removes the least possible amount of skin while still removing all the cancer. This is especially important for lesions on areas such as the ear or face.
WHO PERFORMS MOHS SURGERY?
Training in Mohs surgery requires a one or two year fellowship after completing a dermatology residency. Dr. Massey completed his fellowship in Mohs Micrographic and Cosmetic Surgery at Columbia University in New York.
IS MOHS SURGERY PAINFUL?
No. Mohs surgery is performed with local anesthetic. This means that the area will be made totally numb, so the patient is awake but does not feel any pain.
HOW LONG DOES MOHS SURGERY TAKE?
It is impossible to know before the surgery exactly how extensive the cancer is below the surface. If the cancer is limited to what is seen clinically, then only one or two stages of Mohs surgery may be needed to eradicate the tumor. However, occasionally the cancer extends far beyond what might have been expected and so several stages are required to achieve a cure. As a result, patients may be in the office for just a couple of hours or literally the whole day. Most of this time is spent in the waiting room, talking, eating and reading, while the tissue is being processed and examined under the microscope.
HOW WILL THE WOUND BE REPAIRED?
Once all the cancer has been removed the wound will be assessed and the best reconstructive options discussed with the patient. Sometimes the wound will be left to heal without reconstruction or sutures, in other cases the best cosmetic result can be achieved with a relatively simple repair, while for others complex reconstruction utilizing flaps or grafts may be the best option. Once the most appropriate reconstructive option has been agreed upon, the patient will be scheduled for that surgery, typically the very next day. (Learn more about reconstructive surgery by clicking here.)
IS MOHS SURGERY RIGHT FOR ME?
Mohs surgery is not indicated for every skin cancer. It is most commonly used for;
Your doctor and / or Dr. Massey can discuss with you whether Mohs surgery is right for you.
PATIENT INSTRUCTIONS PRIOR TO MOHS SURGERY