Developed in the 1930s by Dr. Frederick Mohs, a surgeon from the University of Wisconsin, this is the most highly effective technique used for the removal non-melanoma skin cancer. Mohs surgery is reserved for cancers on the face, or those which are recurrent, large, fast-growing, or neglected.
Qualification for Mohs Surgeons
Physicians performing Mohs surgery should have specialized skills in dermatology, dermatologic surgery, and dermatopathology. Basic and advanced training in Mohs surgery is available through certain residency programs, specialized fellowships, observational preceptorships, and intensive training courses. Dr Marsh is a recognized Fellow of the American Society for Mohs Surgery and has performed thousands of surgical procedures.
How is Mohs surgery performed?
The process begins as the skin is numbed with a local anesthetic. The visible cancer is removed with an additional thin layer of normal skin. A detailed map is drawn to properly orient the tumor. The specimen is then color-coded and frozen by our laboratory technician. Thin slices of the removed skin are placed on a slide which may take from 20 minutes to 90 minutes and is the most time consuming part of the surgery.The surgeon examines the skin cancer under the microscope to pinpoint any roots of the cancer. If no cancer is seen at the base or edges then the area is cosmetically repaired. If cancer cells are found, then additional layers of skin are removed only where the tumor is present.This process continues in stages until the tumor has been entirely removed.
How long does Mohs surgery take?
Typically, most cases are completed in 1 to 4 hours. You are awake during the procedure as the operation is carried out using local anesthesia. Please make arrangements to stay the entire morning or afternoon with us.
Will the procedure leave a scar?
Yes. The Mohs technique, however, allows for the smallest surgical scar possible.
What happens after surgery?
Dr. Marsh will discuss with you what type of wound closure would be best (e.g., flap, graft, linear repair, et cetera). Sutures are typically removed in 5 to 7 days. Sometimes it is best to leave the wound open to heal naturally. Occasionally the tumor may be very extensive involving the eyelid, ear, nasal structures, or oral cavity. If this occurs Dr. Marsh will likely refer you to another surgical specialist for assistance in repairing the site so that you achieve optimal results. For very aggressive tumors, low-grade radiation treatments are sometimes used along with Mohs surgery to enhance the effectiveness of the procedure.
Will I have any pain, bruising, or swelling?
Most patients do not complain of significant pain. If there is discomfort, Tylenol is all that is usually necessary for relief. Stronger pain medications can be prescribed if needed. Bruising or swelling usually resolves in about one week.
Will insurance cover the cost of this procedure?
In most instances health care plans cover all, or at least most, of the cost of this procedure. Please check with your insurance carrier regarding coverage, deductibles and co-pay information.
