Harris Dermatology was one of the first dermatologists to bring Mohs Surgery to Southwest Florida. We are trained and proficient in this method for the treatment and removal of skin cancer. Mohs is a surgical technique that has stood the test of time. Developed by Dr. Frederick Mohs in the 1930s, Mohs micrographic surgery has few refinements, come to be embraced over the past decade by an increasing number of surgeons for an ever-widening variety of skin cancers.
What is Mohs Surgery?
Today, Mohs surgery has come to be accepted as the single most effective technique for removing Basal Cell Carcinoma and Squamous Cell Carcinoma (BCCs and SCCs), the two most common skin cancers. It accomplishes the nifty trick of sparing the greatest amount of healthy tissue while also most completely expunging cancer cells; cure rates for BCC and SCC are an unparalleled 98 percent or higher with Mohs, significantly better than the rates for standard excision or any other accepted method.
How Is Mohs Surgery Performed?
The Mohs surgeon marks the area to be treated and removes the visible cancer, along with a sliver of additional tissue. While the patient waits, the removed tissue is carefully marked creating a Mohs “map.” A technician prepares the specimen for the surgeon to examine it under a microscope.
This careful inspection reveals any hidden microscopic “roots” of skin cancers. If remaining cancer is found, the surgeon can use the map to locate and remove hidden cancerous roots from the patient. This part of the procedure is repeated as many times as necessary to remove all parts of the skin cancer, seen and unseen.
How Is Mohs Surgery Performed?
Mohs surgery should only be performed by a specially trained Mohs surgeon. At Harris Dermatology Mohs surgery is performed on an outpatient basis in our offices, only a local anesthetic is needed. Most patients report minimal discomfort and enjoy the convenience of onsite care from our Mohs surgical specialist.
How Long Does The Procedure Take?
Usually the entire procedure takes fewer than four hours, depending on the hidden extent of the cancer. Most insurance policies cover this method of treatment.
Will Mohs Surgery Leave a Scar?
If you undergo Mohs surgery, you can expect to have a scar. The size and characteristics of your scar will depend on the size of your skin cancer and your body's natural healing process. If you have a history of keloids or hypertrophic scars, your doctor may plan a scar treatment program that includes injections or other treatments that will help your body heal more efficiently. Scar maturation can take up to one year after the Mohs procedure. During this time, the skin may contract and appear hard or bumpy. This contraction usually peaks four to six weeks after the procedure and then gradually relaxes. The healing process may also involve the development of new blood vessels around the surgical site to facilitate tissue remodeling. New blood vessel formation can cause the scar to look red for some time. As you recover from your Mohs procedure, your care team remains available to answer questions and discuss the progression of your scar recovery and how to manage it successfully.
Who Should Undergo Mohs Surgery?
Mohs is recommended for most patients who have been diagnosed with high-risk nonmelanoma skin cancer. Due to the high cure rate and conservation of healthy tissue, Mohs is ideal for treating skin cancers on the ears, lips, eyelids, nose, hands, and feet. It is also performed on genital skin cancers. It can also be performed on intermediate-risk skin cancers on other areas of the face, neck, legs, and scalp, as well as those that have difficult-to-see borders.
How Does Mohs Surgery Differ from Other Skin Cancer Removal Techniques?
The Mohs procedure was developed as a way to achieve the best possible results for skin cancer removal. The treatment itself takes longer than most other skin cancer treatments. This is because Mohs is the only method that involves immediate microscopic examination of the removed tissue and its underlying roots. Other methods eliminate cancer cells by either mechanically or chemically destroying them or by excising the known cancerous tissue as well as a small amount of surrounding healthy tissue. By removing slices of tissue and examining each right away, the Mohs procedure reaches the highest rate of success while remaining the most conservative technique in terms of tissue removal.
What Results Should I Expect from Mohs Surgery?
After your Mohs procedure, you can expect minor bruising and swelling. These side effects usually resolve within about a week. You may have some tenderness or soreness in the surgical area. This can be managed with over-the-counter medication taken as directed. You can also apply a cold compress gently over the area for 15 to 20 minutes, a few times a day as needed.
Will My Activity be Limited After Surgery?
You will have a few activity restrictions to follow for one week after your Mohs surgery. Primarily, your doctor will advise you to avoid any strenuous activity that could increase your risk of bleeding, bruising, and swelling. You may not need to take any time off work or most normal activities, but you should refrain from exercise that is more rigorous than walking or casually riding a bike. If you've had Mohs surgery on your head, neck, or face, you should avoid activities that require you to bend over, such as yoga.
What Is Recovery Like From Mohs Surgery?
Afterward, there is minimal discomfort. Generally the area heals naturally with little or no scarring. In rare cases, some scar repair may be desired. Side effects are unusual.