Mohs surgery is a procedure designed to remove certain types of cancerous tissues, and it does so very effectively due to the ability to analyze 100% of the affected skin microscopically. The treatment is most often performed on areas of the face and involves the excision of cancerous skin and examination of the surgical margins under a microscope. Mohs surgery is a unique skill set that not all surgeons possess; however, once a board certified physician thoroughly trained in the procedure is found, patients can feel confident that they will receive the most advanced skin cancer treatment possible.
The procedure is ideal for many patients, but not for all. The location and type of skin cancer, as well as the patient’s general health, may be factors that determine their candidacy. Past skin cancer treatments and their outcomes can also effect if the treatment is the best option. If someone is deemed a poor candidate for Mohs surgery there are several other options available, including cryosurgery, chemotherapy injections, medicated creams, photodynamic therapy, conventional skin cancer surgery, and more.
The types of skin cancer that are typically treated with Mohs surgery include those that have irregular borders and that are likely to reoccur. Skin cancer that is growing quickly, or which has a high risk of spreading to other areas of the body, like some squamous cell carcinomas, can be eliminated more rapidly and efficiently with Mohs surgery than with some other treatments that are performed over an extended period of time. It is also often utilized on areas which have high visibility, such as the nose, forehead, eyelids, and ears.
Benefits of Mohs Surgery
Mohs surgery offers several advantages over other skin cancer treatments that many patients find sway their decision to go through with the procedure. One such benefit is that Mohs Surgery has the highest possible cure rate, which experts suggest is between 95 and 98 percent. Other benefits of Mohs surgery include:
- Pathology results are available within a short time span, reducing the stress associated with waiting
- The preservation of as much healthy tissue as possible
- Smaller scars
- Skin cancer is removed entirely before the wound is repaired, eliminating the need for repeat surgery
- Although seemingly expensive, there can be significant financial savings due to a high cure rate and lack of need for additional procedures
Mohs Surgery and After
Mohs surgery can be a long procedure, but is well worth the time invested in the meticulous extraction of the skin cancer. Performed on an outpatient basis, local anesthetic is injected into the site where the cancer is located. A scalpel is then used to remove the visible cancer and some of the underlying tissue. The tissue sample is sent to a lab and analyzed. The results are almost immediately returned. If there is still cancer present at the margins of the excised tissue, the surgeon will continue to repeat the process until the lab results come back showing the cancer has been completely removed. This may take up to 4 hours or longer, depending on the extent of the patient’s condition. Reconstructive surgery may be necessary following Mohs surgery for patients who had an extensive amount of tissue removed.
Recovery time following Mohs surgery can range from 2 to 4 weeks. This time is dependent on several factors, including the size of the wound, the extent of reconstruction required, and complications that may have occurred. A bandage will need to be worn for 1 to 2 weeks following surgery and will require special care. Most patients feel little soreness, with only some minor tenderness during the first 48 hours. Patients may notice bumps due to redundant tissue or dissolvable sutures from reconstruction. The lumpiness will subside by 3 to 5 weeks. Gentle massage of the area can help speed up the healing process. While there may be some degree of scarring, with Mohs surgery every attempt is made to make the area look as normal as possible. After all, a nearly invisible scar is much easier to live with than skin cancer.
Dr. Ross A. Clevens, MD, FACS, is an Ivy League trained, board certified facial plastic and reconstructive surgeon specializing in surgical and non-surgical procedures of the face and neck, including Mohs surgery for skin cancer removal, brow lift, eyelid surgery, rhinoplasty, Botox and injectable filler treatments, laser skin resurfacing, ear surgery and more. With locations in Melbourne, and Merritt Island, Florida, Clevens Face and Body Specialists can be reached at (321) 727-3223 or online at http://www.clevensfaceandbody.com/.
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Clevens Face and Body Specialists
707 W Eau Gallie Blvd., Melbourne, FL 32935