Mohs surgery is currently one of the most precise and effective medical procedure to get rid of skin cancer. The procedure involves cutting out the infected area and then some. The infected patch of skin is then frozen and cut into sections of skin that are then stained with special dyes. The frozen pieces of skin are further examined under the microscope in which a tumor map is drawn by our Mohs surgeon. 

The layers of skin that are infected are gradually removed until they are clear of any malignant cells. If more cancer cells or “roots” are seen under the microscope, then another skin layer is removed and again examined. This procedure is repeated throughout the surgery. By removing only the tissue where cancer is known to be present, the technique combines a very high cure rate with good preservation of normal skin. Once the cancer has been fully removed, our Mohs surgeon looks at the best method of covering the open wound. 

Mohs surgery removes as much of the malignant cells as possible, or completely gets rid of them. Our doctor doing Mohs surgery can verify the skin cancer has been removed from the person. Usually one treatment is necessary to get rid of the skin cancer. In recent years, there has been medical advances that allow Mohs surgeons to treat Melanoma cells and have resulted in specially made stains that can identify these cells.

What areas does Mohs Surgery cover?

Mohs surgery can be used for any part of the body depending on the patient and the type of skin cancer. For the most part, Mohs surgery is used to treat the head and neck area which are covered in basal skin cells and squamous skin cells but it can also be used in other areas such as hands and feet. Even in the most difficult areas of the head like the nose, lips and ears, Mohs surgery can effectively be used there. If a skin cancer is recurrent in the same area, then Mohs surgery is recommend to remove it. 

Scalp and the neck area are treatable.

The nose, cheeks, ears, forehead and lips can be treated.

Before, During and After the Mohs Surgery

Before the Mohs Surgery

Consult with our Doctors at Miami Dermatology Center to determine if the Mohs surgery is the best course of action to get rid of your skin cancer. Our doctor will discuss with you if you need to abstain from any medications or any specific of beverages. Making sure that you follow our Doctors instructions will make sure the outcome is successful. 

The Mohs Surgery Procedure

Most cancers usually require 1 to 3 stages to be completely removed even though there are exceptions to the rule and it could be more. 

1. Local anesthetics are applied to the area that will be treated so there is little to no pain during the procedure and so the patient can be fully awake while it happens.

2. After the anesthetics are applied our surgeon will remove the visible tumor and put it on a slide to be analyzed under a microscope.

3. A layer of skin underneath the tumor is removed and divided into sections.

4. The sections are color coded and mapped by our Mohs Surgeon

5. The depth of the tumor is removed.

6. The tumor sections are then placed on a slide to be analyzed

7. If cancer is found then our surgeon will map that area and remove tissue. Afterward the surgeon will see which region still has cancerous cell and continue removing sections.

8. The process is repeated until there is no cancer in the skin anymore

After the Mohs Surgery

Once finished our Doctor will discuss with you the options for cosmetic reconstruction. There are times in which the reconstruction can happen on the same day as the surgery. Since Mohs surgery focuses on only the infected areas and does not remove any healthy tissue, it leaves minimal damage in the tissue. 

The surgical wound is closed with stitches to help the skin heal

Even in delicate areas around the eyes, surgical reconstruction is used to minimize scarring

Mohs Surgery Recovery

To recover from Mohs surgery, resting as much as possible the days afterward is recommended. If stitches were applied then the surgeon will let you know when to return get them removed. Most patients can go back to work or school after the procedure. Doing strenuous exercise is to be avoided after the removal of cancer cells. If any discomfort is felt, then some Tylenol or other painkillers might be prescribed. 

Advantages of Mohs Micrographic Surgery

The way that Mohs surgery is performed allows our Doctors to effectively remove all the cancerous tissue in the person’s skin. Our doctor is a Mohs surgery certified surgeon and is qualified to interpret the skin histopathology and aid with any post-surgery defects. Our dermatologist is trained to find the areas in which the cancer is concentrated in and extract them. Some of the advantages of Mohs Surgery are the following:

• We ensure cancer removal
• Abolishes the chance of cancer coming back
• Reduces the amount of healthy skin tissue lost
• Cosmetic recovery is maximized
• Could possibly repair the site of cancer the same day
• Most Precise cancer removal technique
• Treats Basal Cell Carcinoma and Squamous Cell Carcinoma Cancer
• 1 Single treatment is usually required

Success Rate of Mohs Surgery

99%

The Mohs surgery works by removing only the layers of skin that are infected with skin cancer cells. There is a 99% Success Rate for the Mohs Surgery with little to no chance the skin cancer will come back after surgery. Mohs Surgery is considered to be the highest standard when it comes to dealing with skin cancer.

How long does a Mohs Micrographic surgery take?

1-4 Hours

The entire Mohs micrographic surgery time varies depending on the severity and size of the skin cancer. The entire procedure can last anywhere from one to four hours, but can last more if necessary. When the surgeon removes the first layer of skin tissue then it will be examined and you have to wait for about 30 minutes. Afterwards after the examination, the surgeon will determine if another layer is necessary or if you can get stitched up. The patient will spend most of the time waiting for the skin to be analyzed. 

History of Mohs Micrographic Surgery

Mohs is not an acronym but it is the name for the founder of the surgery technique. Mohs micrographic surgery was invented by Frederic E. Mohs, MD. When he was in school studying medicine during the late 1920’s he was mentored by a professor who specialized in the preparation of frozen tissue and producing microscopic slides. Using what he had learned about microscopic performance, he was able to map out cancer around nerves, blood vessels and any bones

When he examined a cancer he would extract it with a thin disc of tissue so he could completely infiltrate the cancer. After finishing school he began his practice in 1936 and successfully treated his first patient with a squamous cell cancer. He spent four years refining his practice and perfecting his procedure. Throughout time the Mohs Micrographic surgery was improved with color-codded mapping and a more detailed microscopic examination.