What is Mohs Micrographic Surgery?
Mohs surgery is a highly specialized treatment for the removal of skin cancer. This method differs from all other methods of treatment of skin cancer by using a microscopic examination of all tissue removed surgically, as well as detailed mapping techniques to allow the surgeon to track and remove all of the roots and extensions of the skin cancer. Mohs surgery is used in treating skin cancers that have a high risk of recurrence or are located in cosmetically sensitive areas such as the face, nose, ears, and eyelids.
How effective is it?
Mohs surgery is the most accurate method for removing skin cancers, even when previous forms of treatment have failed. The cure rate with Mohs surgery is 99 percent and Mohs surgery is 95 percent effective. No procedure can guarantee that the cancer will never return. With Mohs surgery, however, your cure rate will be maximized.
Will the surgery leave a scar?
Yes, sometimes a scar can remain. However, in many instances there is no scar or the scarring is very minimal. Patients should keep in mind that with any surgical treatment there is always a risk of possible scarring. However, because Mohs Surgery removes as little normal tissue as possible, scarring is minimized.
Will I have pain or bruising after surgery?
Most patients do not complain of pain. If there is any discomfort, Tylenol is all that is usually necessary for relief.
You may be asked to have a preoperative visit prior to undergoing surgery. This visit will give you the opportunity to meet your doctor and his medical staff, and learn more about Mohs Micrographic Surgery. An examination of the cancer will be performed and a medical history will be obtained. Occasionally, some preoperative tests will be ordered.
Reconstruction options may also be discussed. You will have the opportunity to ask any questions you have relating to your upcoming surgery.
On the day of surgery
- Eat a good breakfast.
- Wear loose-fitting clothing. We recommend clothing that can be unbuttoned and removed.
- Follow any preoperative instructions given to you.
- You may need to bring someone to drive you home. However, we recommend that you only bring one person due to space considerations in our waiting room.
- Plan to arrive at least 15 minutes early so that a medical chart can be prepared.
Your appointment will be scheduled early in the day.
The surgical procedure alone takes only 10-15 minutes. However, it takes a minimum of 60-90 minutes to prepare and microscopically examine the tissues. Several surgical stages and microscopic examinations may be required, and you will be asked to wait between stages.
We would like to make the time you spend with us as pleasant and comfortable as possible. You may want to bring reading material to occupy your time while waiting for the microscopic slides to be processed and examined. Magazines will be available in the waiting room area.
The most difficult part of the procedure is waiting for the results of the surgery. Since we do not know in advance how much time is necessary to remove the cancer and repair the wound, we ask that you make no other commitments for the entire day on which you are scheduled for surgery.
The reconstruction after the cancer is removed
Immediately after the cancer is removed, we may choose 1) to allow the wound to heal by itself, 2) to repair the wound with stitches or a skin graft or flap, or 3) to send you to the referring physician or another surgical specialist for wound repair.
The decision is based on the safest method that will provide the best cosmetic result. When the reconstruction is to be completed by another surgical specialist, it may take place on the same day or a subsequent day.
Is hospitalization necessary?
No. Mohs surgery is performed in our office and you may return home the same day.
Usually only one or two return visits are needed to remove stitches or examine the healed surgical site. Afterwards, you may return annually for routine check-ups.
A follow-up period of five years for the treated cancer is essential. After having one skin cancer, statistics show that you have a higher chance of developing a second skin cancer. You should have your skin checked at least once a year, not only to examine the treated skin cancers, but also to check for new skin cancers.
How can future skin cancers be prevented?
The best protection from skin cancer is to avoid the harmful ultraviolet rays of the sun. Even if you tan easily, the sun can contribute to skin cancer. Minimize your exposure by using a sunscreen with a sun protective factor (SPF) of at least 30 when you spend any time in the sun, wearing broad brimmed hats,
minimizing sun exposure during midday hours (10 am to 2 pm), and using sun protection even on cloudy days since the ultraviolet light penetrates easily through the clouds. With adequate protection, you should be able to enjoy most of your normal daily activities without significantly increasing your risk of future skin cancers.
Will my insurance cover the cost of surgery?
Most insurance policies cover the cost of Mohs surgery. However, you should check with your carrier for exact information related to their schedule of payments. On your first visit please bring a copy of your I.D. card and insurance card.