Mohs Surgery

Despite more public awareness about skin cancer and what causes it, an estimated two million people are diagnosed with some type of skin cancer each year in the United States. And according to the Skin Cancer Foundation, one person dies every hour from melanoma, the most deadly form of skin cancer. 

Despite those high numbers, it is also true that most skin cancers, the more common basal and squamous cell cancers, have a very high cure rate if diagnosed and treated early. In fact, the primary surgical procedure to remove skin cancer, Mohs surgery, is credited with curing 99 percent of initial cancers and 95 percent of recurrent cancers, including even some melanoma. 

In a nutshell, Mohs surgery, developed in 1930 by Dr. Frederic Mohs, is a form of micrographic surgery in which the surgeon removes tissue, maps it with a microscope and then determines where to cut next. The procedure is repeated until all traces of the cancer are removed, and the maximum amount of healthy tissue is preserved. 

Mohs surgery, however, usually results in scarring and deformities in aesthetic areas like the face and neck. So, reconstructive surgery is often needed. Sometimes, this is done by the Mohs surgeon – usually a specially trained dermatologist – and sometimes, by a separate Mohs plastic surgeon. 

One drawback with Mohs surgery is that the procedure is sometimes lengthy. It is usually done on an outpatient basis under local anesthetic, as the patient waits. The process of cutting and mapping can take an entire day, depending on how much cancer is found. This obviously requires a lot of patience on the part of the patient, and a great focus on the part of the Mohs surgeon.

Mohs Surgery for Skin Cancer

Over 2 million new cases of skin cancer are reported in the United States each year.  Most skin cancers are classified as non-melanomas  and affect the basal or squamous cells. Melanoma skin cancers start in the melanocytes and are much more dangerous than non-melanomas. 

Both types of skin cancers have a high rate of cure if they are detected and treated early enough.  Mohs surgery is one of the most effective treatments for basal and squamaous cell skin cancers. Studies have shown that Mohs surgery has a cure rate of over 99% for initial cancers and 95% for recurrent cancers.  Mohs surgery can also be used to treat melanomas in certain situations.

One of the most important considerations in treating skin cancer is the removal of the entire tumor which is usually not completely visible to the naked eye.  When the tumor is on the face or other exposed area of the body, the goal is to remove all of the tumor while minimizing the removal of healthy tissue to minimize unsightly scarring. 

Mohs surgery is a microscopic surgery that removes all of the cancerous tissue while ensuring the maximum amount of healthy tissue is retained.  The surgery is usually performed on an outpatient basis using local anesthesia.

For skin cancers on the face, the best aesthetic outcomes are often achieved by using a Mohs surgical team that includes a Mohs surgeon and a facial plastic surgeon who specializes in Mohs surgery.  The Mohs surgeon will remove the tumor and the facial plastic surgeon will close the wound which results in the highest possible cure rate and minimal visible scarring.