Skin cancer often has roots that are not visible to the naked eye. Mohs Micrographic Surgery is a specialized method to remove skin cancer that spares healthy tissue surrounding the tumor and provides the patient with the peace of mind in knowing that there are free of skin cancer upon leaving the office. In addition to basal cell and squamous cell cancer, Mohs surgery is used to treat many other less commonly see skin cancers such as atypical fibroxanthoma, sebaceous carcinoma, dermatofibrosarcoma protuberans, etc.
The Mohs surgeon takes a very thin margin around what appears clinically to be the tumor on the surface. The specimen is then processed into frozen sections in the laboratory on the premises. Within, 45 minutes to 1 hour, you will know whether or not you are cancer-free. If there is a need to remove more of the tumor, it will be precisely delineated on a map as to exactly where the tumor cells still persist in relation to the surrounding anatomy. The entire procedure in performed under local anesthesia, much like the process carried out when the initial biopsy was taken.
Conventional surgical removal of skin cancers consists of taking wider margins without knowing whether or not the margins are clear. With Mohs surgery, complete removal of skin cancer approaches 99% and has the lowest rate of recurrence as compared with other modalities used to treat skin cancer. In most cases, after the skin cancer is completely removed, the defect created from the surgery will require closure or reconstruction. The Mohs surgeon will design and carry out an appropriate repair that will maximize the best cosmetic outcome and minimize the scar. The vast majority of repairs are done the same day in the office following Mohs surgery. If more advanced reconstruction is required, you will be referred to one of several premier facial plastic reconstructive surgeons that our office has had a professional relationship with for decades.