Mohs Surgery

What is Mohs surgery?

Mohs surgery is a treatment for skin cancer with considerable benefits over other removal options when it’s applicable. It has the highest potential to resolve skin cancer even if the cancer has recurred after earlier treatment. 

During Mohs surgery, Dr. Brian Pucevich surgically removes a very fine layer of the cancerous lesion after injecting local anesthesia. Slides are created and processed within the office by a trained Mohs technician. Dr. Brian then examines the cells under a microscope, to help him locate any remaining cancerous cells and determine if more tissue should be taken and the exact location.

This process is repeated until Dr. Brian no longer detects any cancerous cells. Mohs surgery minimizes the amount of healthy cells and tissue removed with the cancer, preventing noticeable scarring or disfigurement, especially in delicate areas like your face, scalp, hands, or genitals.

When is Mohs surgery the best choice for skin cancer treatment?

Your general dermatologist will evaluate your skin cancer, make a diagnosis, and recommend treatment based on the details of your case. Mohs surgery isn’t always recommended but is often useful to treat basal cell carcinoma and squamous cell carcinoma. It’s also an option in certain rare cases of melanoma.

Your dermatologist might recommend Mohs surgery if your skin cancer is:

• Recurrent or at risk of recurring
• Blurred at the borders
• In an area where you want to preserve as much tissue as possible
• Particularly large or aggressive

If Mohs surgery isn’t the best option, other cancer treatments include conventional excision, cryosurgery, and systemic treatments like radiation or chemotherapy. 

How should I prepare for Mohs surgery?

Mohs surgery is a procedure performed on an outpatient basis in the office. Patients should be prepared to spend the entire day in the office because the surgery is performed in steps or stages. The number of steps or stages required depends upon the size and depth of the cancer and can be unpredictable.

Slide preparation in between layers typically takes one hour, so keep in mind the procedure involves significant waiting time as your surgeon examines each skin sample under a microscope.

Eat a full breakfast and bring a packed lunch or snacks along with some reading material. The office does provide free WiFi for patient use, so bringing a tablet or laptop may help pass the time between stages. In many cases, elderly patients may appreciate a driver and the company of a friend or relative on their surgery day.

Once the area is cancer-free, Dr. Brian will discuss the options for wound healing and surgical repair. A Mohs surgeon is trained extensively in reconstructive procedures to repair the wound on the same day. On rare occasions, if a defect is large enough to require sedation, another surgical specialist with unique skills may complete the reconstruction.

If your general dermatologist recommends Mohs Surgery for treating skin cancer, Dermatology Associates’ scheduling team will collect all needed documentation from the referring provider. They will then explain the surgery procedure and send an educational brochure so that you’re prepared for your surgery day.