About Mohs Surgery
What is Mohs surgery?
Mohs surgery is a highly specialized procedure that relies on the accuracy of the microscope, instead of the human eye, to ensure that all cancer cells are removed when a skin cancer is treated. It is named after Dr. Frederic Mohs who developed the technique in the 1930’s. With Mohs surgery, unlike standard surgical excision, 100% of the surgical margin is evaluated by the surgeon to detect “roots” of the skin cancer. Hence, Mohs Surgery offers the highest cure rate (99% for primary BCC and SCC) while sparing normal tissue. Mohs surgery requires the specialized skill and training of a Mohs dermatologic surgeon who serves as surgeon, pathologist and reconstructive surgeon. Dr. Hendi has performed over 10,000 cases of Mohs surgery and is strongly committed to patient care and the treatment of skin cancers, with a focus on achieving superior cosmetic outcomes.
What happens the day of surgery?
Our staff will escort you into the surgical suite where Dr. Hendi will numb the area around the skin cancer. Once it is numb, the visible cancer and a thin layer of tissue will be removed. This tissue is carefully mapped by Dr. Hendi and taken to our laboratory where the technician prepares slides to be examined under the microscope. You will have a temporary bandage placed over the wound and you will be free to return to the waiting room.
The surgical procedure alone takes only 10-15 minutes. However, it takes a minimum of 1-2 hours to prepare and examine the slide for each layer. If you are being treated for melanoma, we use a state-of-the-art MART-1 immunostain which takes longer to process, up to 4 hours. Several stages may be required to completely remove every cancer cell. You will be asked to wait in the waiting room between stages. Although there is no way to tell how many stages will be necessary, most skin cancers are removed in three stages or less.
The most difficult part of the procedure may be waiting for the results. Since we do not know in advance how much time is necessary to completely remove your skin cancer, we ask that you make no other commitments the day of your surgery. After your skin cancer is completely removed, the open area of skin may be closed with stitches. This will be done in our outpatient surgical facility the same day or the following day.
What complications may occur?
Complications after Mohs surgery are rare, but may include a chance of bleeding or infection. For any complications or questions after surgery, please review the written instructions we will provide on the day of surgery.
Will I be hospitalized?
No, Mohs surgery is performed in a pleasant out-patient surgical facility and you may return home the same day. Our Medicare and AAAHC accredited surgical facility is designed so that we can provide the highest level of outpatient care, with your safety and comfort in mind.
Will the surgery leave a scar?
Yes, any form of treatment will leave a scar. However, because Mohs surgery removes as little normal tissue as possible, scarring is minimized. Immediately after the cancer is removed, we may choose to:
- Leave the wound open to heal itself
- Repair the wound with stitches that will result in a scar 3x to 5x the length of the Mohs defect for the best cosmetic result
- Close the wound with a skin flap or graft
This decision is based on the safest method that will provide the best cosmetic results. As Dr. Hendi will tell you, our goal is to “cure you and keep your good looks.” Rarely other surgical specialists may be utilized for their unique skills if warranted.
Will I have pain after surgery?
Most patients do not complain of pain. If there is any discomfort, Tylenol and Advil is all that is usually necessary for relief. A sensation of tightness and itching is normal after surgery and may take months to resolve.