What is Mohs surgery?

Mohs surgery, or Mohs micrographic surgery (MMS), named after its originator Frederic E. Mohs, MD, is a specialized procedure used to treat specific forms of skin cancer. Unlike most surgeries for skin cancer, Mohs has a unique benefit: when you go home after your procedure, your skin cancer will be gone!

Who performs Mohs surgery?

Mohs surgery is performed by board certified dermatologists who are specially trained to fulfill three roles:

  1. As the surgeon who removes the cancerous tissue
  2. As the pathologist who analyzes the lab specimens
  3. As the surgeon who closes or reconstructs the wound

While any board certified dermatologist may perform Mohs surgery, only members of the American College of Mohs Surgery (ACMS) have undergone rigorous fellowship training. 

Is Mohs surgery right for me?

Most patients who undergo Mohs surgery have been diagnosed with either basal cell carcinoma or squamous cell carcinoma.

Indications for Mohs surgery include skin cancers that:

  • Develop on areas where preserving cosmetic appearance and function are important (e.g., head and neck)
  • Have recurred after previous treatment or are likely to recur
  • Are located in scar tissue
  • Are large
  • Grow rapidly
  • Have borders that are ill-defined

It is very important to get regular skin checks with a dermatologist so that these cases can be diagnosed early and treated as soon as possible.

Mohs surgery is not an appropriate treatment for all forms of skin cancer, so you and your doctor should discuss the best treatment for your specific case.

What can I expect?

For the patient, Mohs surgery is relatively easy. It is an outpatient surgery wherein you will receive a local anesthetic and be awake and alert during the surgery.

Once the anesthetic takes effect, the surgery will begin. The procedure is done in stages, all in one office visit, while the patient waits between each stage. Dr. Rizzo will start by cutting out the visible skin cancer, along with a thin layer of surrounding skin, to test the edges for microscopic cancer cells (roots). The treatment area will be bandaged temporarily and you will be kept very comfortable while he examines that layer beneath a microscope.

Upon examination, if Dr. Rizzo finds that any cancerous roots remain, he will know the exact area where they are and remove another layer of tissue from that precise location, sparing as much healthy tissue as possible. He will repeat this process until no cancer cells remain.

Once he is confident that all cancer cells have been removed, you and Dr. Rizzo together will determine how the post-treatment wound will be repaired.

Because it is impossible to know the extent of the cancer in advance of treatment, reconstruction plans can vary. Fellowship-trained Mohs College surgeons have specialized reconstructive and plastic surgery training for repairing wounds. Based on the size and location of your post-treatment wound, one of the following reconstructive options will be selected:

  • Small, simple wounds may be allowed to heal by themselves in a process known as secondary-intention healing.
  • Slightly larger wounds may be closed with stitches in a side-to-side fashion.
  • Larger or more complicated wounds may require a skin graft from another area of the body or a flap, which closes the defect with skin adjacent to the wound.
  • On rare occasions, the patient may be referred to another reconstructive surgery specialist.

Post-operative care

Most patients find the recovery process for Mohs surgery very easy.

Dr. Rizzo and his skilled staff will give you a number of different aftercare instructions.

These instructions may include:

  • When you should change any bandages
  • How to properly clean the surgical site
  • When you can return to regular activity, such as exercising or wearing body creams or makeup
  • A schedule for follow-up appointments
  • Care instructions for treating your surgical scar

Advantages of Mohs Surgery

Highest Cure Rates

Success rate of 99 percent for primary tumors.

Cost-effective And Efficient

Single-visit outpatient surgery using local anesthesia.

One Afternoon

Most procedures completed in just a few hours. No spending all day at a surgical center or hospital.

Same-Day Peace Of Mind

No waiting weeks for biopsy results — lab work is done on-site so you can leave the office cancer-free.

No Big Scars or Gouges

Minimally invasive (spares healthy tissue). Best cosmetic results of any skin cancer treatment.

Easy Recovery

Most post-treatment wounds heal on their own or require only minimal reconstructive surgery.

Am I a candidate for Mohs surgery?

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