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
Loose extra skin on the upper eyelids or bags and wrinkles of the lower lids can make you look tired and add years to your appearance. This can be corrected with a safe cosmetic surgery called blepharoplasty. This surgery can rejuvenate your eyes and take away that sleepy, tired look. Dr. Massey has perfected an “electrode blepharoplasty” that can be performed under the safety of local anesthesia, with practically no down time. The procedure take about 45 minutes and patients can usually be back to full activity after one week.Learn More
With time the effects of gravity can show themselves as loose extra skin on the cheeks and jowls. These can add years to your appearance. The old fashioned type of face-lift required general anesthetic, many weeks of down time and often left patients looking “unnatural” with their skin pulled much too tight. With the new “Lipo-Lift” Dr. Massey has integrated a new, less invasive face-lift procedure with the tissue contraction gained from micro-liposuction and the benefits of tumescent anesthesia, to produce amazing results. As soon as ten days later, patients don’t look like they have just had surgery, they just look better!Learn More
Until recently, procedures for body contouring through fat removal involved extensive operations. These resulted in large scars and significant safety risks. Several years ago, dermatologists developed tumescent liposuction. This allows fat removal through tiny incisions that do not leave significantly visible scars. A large volume of extremely dilute local anesthetic is infiltrated into the area to be treated. Then utilizing straw like, extremely thin metal tubes (cannulas) and a high-pressure suction system, the fat cells are extracted through tiny incisions.Learn More
A heavy, drooping forehead and eyebrows (rather than just eyelids) can give a sleepy, tired look. Many of these patients are mistakenly treated with a blepharoplasty alone, which takes extra skin from the upper eyelids, still leaving them with their flat, “heavy” eyebrows shadowing their eyes. If these patients are correctly diagnosed preoperatively, they can get a much better cosmetic result from a brow lift, either alone or in combination with blepharoplasty. This is the type of careful analysis and deeper knowledge that allows Dr Massey to guide patients towards the best procedure for them.Learn More