"Mohs micrographic surgery is a safe and highly effective treatment for skin cancer. It is primarily used to treat basal and squamous cell carcinomas, the two most common types of skin cancer, although it can be used for melanoma and other types of cancer. Mohs surgery is often recommended for recurring cancers, as well as those in difficult-to-treat areas, such as the nose, eyelids, lips, hairline, hands, feet, and genitals, in which preserving as much tissue as possible is extremely important.
During Mohs surgery, cancerous tissue is removed in small sections. While the patient waits, a pathologist examines each tissue specimen for malignant cells. If malignant cells are found, more tissue is removed until the cancer is eradicated. This comprehensive microscopic examination helps to target only cancerous tissue, significantly reducing damage to healthy surrounding tissue. The surgery excises not only the visible tumor but any "roots" extending beneath the surface of the skin. Five-year cure rates of up to 99% for first-time cancers and 95% for recurring cancers have been documented.
Mohs surgery is performed as an outpatient procedure in our office. During Mohs surgery, the treatment area is numbed with a local anesthetic. Small layers of skin are removed, and each layer is examined microscopically to see if it contains malignant cells. Excision continues until the cancer is completely removed. Most Mohs procedures can be performed in three or fewer stages, and take approximately 4 hours.
After Mohs surgery, patients experience mild discomfort, bleeding, bruising and swelling. Pain medication is prescribed if needed, although most patients require only over-the-counter medication.
Mohs surgery leaves scars, although they are often smaller than those from other excision procedures. Reconstructive procedures, including skin flaps and skin grafts, can reduce the prominence of, or even eliminate, scars; they can be performed at the same time as the Mohs surgery or at a later date. If possible, surgical techniques, including placing stitches in the skin's natural creases or out-of-sight areas, are used to make scarring less visible.
In addition to the risks associated with any surgery, those related to Mohs surgery include the following:
Temporary/permanent surgical-area numbness
Temporary/permanent surgical-area weakness
Following Mohs surgery, regular doctor visits to check that cancer has not recurred or that new cancer has not grown are recommended."