MOHS Surgery

Mohs Skin Cancer Surgery

Mohs micrographic surgery has a 99% cure rate. It is the most effective skin cancer treatment available.

What is Mohs?

Mohs Surgery is a highly specialized procedure for the total removal of skin cancers. Mohs surgery is named in honor of Dr. Frederic Mohs, the physician who developed the technique. This method differs from all other methods of treating skin cancer.  It uses a layer by layer method of removing skin cancer, with microscopic examination of 100% of the removed tissue margins.  This procedure yields a cure rate of over 99%.  Although other surgical specialists may check excision margins, this form of pathologic examination of the tissue is not the same as Mohs surgery.

Your diagnosis of skin cancer and Mohs surgery

A diagnosis of skin cancer can be frightening. It is important to know the facts. Not all treatments for skin cancer are the same. Mohs micrographic skin cancer surgery is a process that will remove all the cancer, minimize the risk of recurrence, and leave the smallest scar possible. Mohs micrographic surgery is effective for most types of skin cancer, but is most commonly used to treat basal and squamous cell carcinomas.

There are many advantages to Mohs surgery compared to other skin cancer treatments including its high cure rate and cost-effectiveness.  It is especially appropriate for skin cancers that:

  • Are located on a part of the body such as the nose, eye, ear, or lip where preserving cosmetic appearance and function are important
  • Have recurred after previous treatment or are likely to recur
  • The margin or the extent of a tumor cannot be easily defined
  • Grow rapidly or are large
  • Are located in scar tissue

With a 99% cure rate, Mohs surgery is the most effective skin cancer treatment available.

Your Mohs Surgery

Your surgery will be performed on an outpatient basis under local anesthesia.  The procedure usually lasts several hours (3-5 hours average), but patients should be prepared to stay all day if necessary.  The procedure starts by numbing the skin cancer and surrounding skin by injections of local anesthesia.  The skin cancer is then removed and the tissue is mapped and diagrammed and processed in our in-house laboratory.  In the lab, the specimen is frozen and thinly sliced and placed on glass slides.  Dr. Braza will examine the slides under a microscope to determine if any cancer remains on the edges of the tissue.
If skin cancer is found at the edge, then more tissue is removed from the wound and the entire process (called a Mohs stage) is repeated until all the margins are found to be clear of the skin cancer.  Most cancers are removed in 3 stages or less.  Once the cancer is clear, reconstruction options will be discussed.

The day of surgery, we recommend the following:

  • Get a good night’s sleep and eat breakfast.
  • Take medications unless we tell you otherwise.
  • Bring something to do, such as reading material or work material.
  • We ask that you bring one friend or relative as company.

Mohs surgery preserves as much healthy skin as possible leaving the smallest defect which helps minimize scarring.  Once Dr. Braza has completely removed your skin cancer, he may choose to leave the wound to heal itself, to repair the wound with stitches, or reconstruct the area with a skin graft or flap.  The decision is based on the safest method that will provide the best cosmetic result.  In most cases, Dr. Braza will repair the area left by the cancer.  If necessary, Dr. Ed Ricciardelli (the board certified plastic surgeon at the Summit) will do the reconstruction of the area.  The Summit surgical team is available for you throughout the healing process to discuss any concerns that may arise.