What is Mohs Surgery?

Mohs surgery differs from other skin cancers treatments in that it permits the immediate microscopic examination of the removed cancerous tissue. Mohs surgery utilizes a real time evaluation of the cancer while you are in the office to allow for us to take the least amount of tissue while also ensuring that you are cancer free.

The Mohs procedure itself involves removing the visible portions of the skin cancer, along with a layer of the surrounding skin. In standard Mohs surgery, it is the surgeon who then processes and reads the slides of the skin. Instead of acting as both the surgeon and the dermatopathologist (a pathologist who only reads skin specimens), we hire a dermatopathologist to bring a staff and their mobile lab unit to process the tissue. This allows us as the surgeon to tend to your defect and focus on giving you the best cosmetic result.

Once the initial layer with margins of skin are removed, it is marked to know the orientation and then is hand delivered to the Dermatopathologist to process, stain, and read the slides.  This process usually will take approximately 10-15 minutes on average. Once the slides have been read, the dermatopathologist reviews the report with one of our providers to discuss the margins of the cancer. If the margins are free of cancer, we proceed to repairing the defect with precision sutures and plastic surgery grade technique. If the margins are still present with cancer, additional tissue will be removed from the areas indicated as positive and the process repeats until cancer free margins are obtained.

Using our unique method of mohs surgery allows for each specialty to focus on the task at hand. At Ocean Drive Dermatology, we want to ensure that you are cancer free while also ensuring that you obtain the best cosmetic result. With the hiring of a Dermatopathologist we are safeguarding that you have the highest level of care taken in the evaluation of the specimens, while also ensuring that we have the time to give you the best cosmetic outcome.

Candidates for Mohs Surgery:

Mohs surgery us the preferred treatment of skin cancer found from the nose, ears, face, scalp, neck, hands, feet, and genitalia, where preserving the surrounding healthy tissue is critical for functional and/or cosmetic purposes. Mohs surgery can also be used in cases where there is a recurrence of skin cancer or if the area of skin cancer is large enough.

 

Effectiveness and Advantages of Mohs Surgery:

Skin cancers can often be very deceptive. The truth about skin cancers are that we do not know how wide or how deep they go until we get to the end of the surgery. Although we start mohs surgery by taking the area of skin that the cancer seems to be present on, there are times that the cancer has spread under the skin or along blood vessels, nerves, or cartilage. Mohs surgery is specifically designed to remove these cancers by tracking and removing these cancerous roots.

It is important to remember that Mohs surgery only removes the cancerous tissue and leaves the normal tissue untouched.

 

Insurance Coverage for Mohs Surgery:

Most insurance policies cover the procedure and reconstruction.

 

What to Expect After Surgery?

Most patients do not complain of significant pain. We often recommend Tylenol for the moderate amount of discomfort that one may experience. Stronger medications are available and will be considered on an as needed basis.

 

Will I Have Sutures?

Most patients will have two-to-three layers of sutures depending on the location. For most patients, they will have a layer of sutures underneath the skin and a layer of sutures above of the skin. The sutures above the skin will have to be taken out and that typically takes place within 7-14 days after the surgery. The sutures underneath the skin will dissolve on their own and do not need to be removed.

 

Do I Need to Have Someone Drive Me?

Most people can drive themselves to and from the procedure.

 

What do I need to after the surgery?

Wound care instructions will be reviewed, and a typed sheet will be given the day of surgery.