Mohs surgery is a precise surgical procedure used to address complex skin cancers. Mohs surgery is often known as mohs micrographic surgery. The most prevalent skin cancers, such as basal cancer and squamous cell cancer, are easily treated with mohs surgery.
It is especially useful for skin cancers in complicated areas like lips, nose, ears and genitals. Mohs surgery is a proven provider of highest cure rate as well as the lowest chance of re-growth. This procedure has several benefits. It is a one-day outpatient surgical treatment and is the most affordable treatment of skin cancer. It offers the highest cure rate for non-melanoma skin cancer with a five-year cure rate exceeding 99 percent for new cancers.
Is mohs surgery right for you?
You are a candidate for mohs surgery when:
- The skin cancer is in a place of increased cancer re-growth
- The cancer is large
- The cancer was treated in the past and recurred
- The sides of the cancer is not clearly identified
- The affected person is at risk of having several skin cancers
- The cancer develops rapidly and uncontrollably
- The cancer keeps growing in an area previously treated by radiation therapy
- The sufferer is immunosuppressed, such as those who have had an organ transplant, are HIV positive and have persistent lymphocytic leukemia.
How do I prepare for surgery?
You can eat breakfast and lunch as well as snacks on the day of mohs surgery unless otherwise instructed by the surgeon. Please take all of your regularly prescribed medications until the doctor has suggested you.
Many mohs surgeons are specially trained dermatologists. There are many cosmetic surgeons who are also trained to execute mohs surgery. But, many mohs surgeons treat basal and squamous cell cancers by using this technique. The goal of mohs is to clear skin cancer, achieve the smallest scar and preserve normal tissue.
While in mohs surgery, your surgeon will start to clear out the skin cancer and a small amount of healthy tissue, a single layer of skin at a time. Each and every tissue layer is prepared and screened under the microscope for cancer cells. Surgery is complete when no more cancer cells are recognized.
Mohs micrographic surgery can take place in two or more stages. During the first stage, the surgeon suggests the patient to stop aspirin and other medications which avoid blood clotting. It is an outpatient procedure, in which the surgeon injects the local anesthesia into the cancer affected area. You will experience mild pain during the injection of local anesthesia. Using a curette, which is a device designed like a spoon, the surgeon extracts the cancerous growth along with 1/16th of an inch of healthy skin tissue. The total process will take only 10 to 15 minutes.
In second stage, the surgeon makes a map of the cancerous site, which he or she will use as a guide in the next stages of the process. If there is evidence of cancer, the surgeon will mark the cancer location on the map and one more layer of tissue is extracted from the area where the cancer is found. This procedure continues layer by layer until the cancer is removed completely. Sometimes, based on the form of cancer and its extent, post-operative radiation therapy can be suggested following surgical treatment.
Mohs surgery is often performed on the face, neck and head. It is also sometimes advised for repeated and aggressive skin cancer on other areas of the body. One of the best things you may expect after mohs surgery is a smaller wound problem and higher cure rate than any other surgical procedure used to treat skin cancers.
Will mohs surgery leave a scar?
Any surgical removal of skin cancer will leave a scar. But many scars are more visible based on the area and skin type. There are various options for treating surgical scars, which include lasers, scar creams and gels, cortisone injections and many other alternatives depending on the surgical mark.
How long does the procedure take?
The time spent to perform the surgery is only about 15 minutes for every stage; the complete mohs surgery may take between two to four hours. Most of this time is invested freezing the tissue and preparing slides. Tissue preparation usually takes between 30 and 60 minutes for every stage.
What is the cost of the procedure?
The cost depends on several factors, such as complexity and repair. Consulting a mohs surgeon will give you the precise cost analysis. An experienced physician can better evaluate the condition, find out the complexity of the procedure and also the reconstruction that is needed.
There are a few minor risks involved in the surgery, such as bleeding, infection of the wound, scarring, discomfort and pain.
Recovery time depends on several factors. Some of these factors include the location, the length of the defect post-operatively and the type of restore performed. Healing process may be between 2 to 4 weeks. Your stitches are generally taken out about two weeks after the surgery. In many cases, patients will not experience any pain. If you experience any pain and discomfort, the doctor may advice an over-the-counter pain reliever like Tylenol.
You may receive detailed instructions for care after mohs surgery which includes:
- Your surgical wound will need care during the weeks after the surgery.
- You need to wear a bandage for 10-14 days.
- Avoid strenuous activity like exercise and heavy lifting for at least 2 weeks following the surgery.
- Avoid heavy bending for at least two to three days.
- Also avoid exposure to sun’s rays as much as possible. Apply SPF 30 or higher sunscreen at least 10 minutes prior to sun exposure.
- Ask your surgeon about the adequate protection from sun’s rays.
Follow-up after mohs surgery:
It is important to make a scheduled appointment and see your referring dermatology for a full skin examine 3-6 months after the mohs surgery. Regular skin surveillance is very important for early detection and prevention of skin cancer. You need to be examined:
- Every three months in the first year
- Every six months in the second year
- Yearly until five years have passed