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.
