What is Mohs Surgery?
Mohs Micrographic Surgery, or chemosurgery, is a highly effective, highly detailed surgery that is common in treating primary basal cell carcinoma. It is also used to treat melanoma-in-situ as well as squamous cell carcinoma. Micrographic surgery involves a doctor cutting out cancerous skin lesions starting from the bottom of the tumor and working up to the top layer of the skin. After the skin layers are removed, they are immediately examined through a process called histology. This consists of microscopically examining tissue that have been frozen and treated with a special dye to determine if any more cancer remains.
Since this is such a detailed surgery, which requires special skill and expertise, it is important to go to a highly trained and experienced dermatologist, such as Dr. Matthew Barrows. His team is skilled in performing micrographic surgery successfully and effectively. In addition, Dr. Barrows’ practice has a plastic surgeon on site who can work with patients post-surgery to minimize scarring.
A doctor will use a local anesthetic to numb the surgery site. Then, he or she will begin to excise, or cut, horizontal layers of the cancer starting from the bottom-most layer. The layer will immediately be frozen, treated with dye and looked at under a microscope. A tumor map is generated to see if any more cancerous cells remain. This allows for an immediate microscopic examination of the excised cells, which is known as tissue histology. If more cancer cells are discovered, another layer of skin will be removed. This process will continue until there is no more cancer present. Once complete, the doctor will examine the wound and will either use sutures to stitch it up, or in some case, call in our plastic surgeon for further consultation.
Mohs Micrographic Surgery Reviews
"I've been very pleased with Dr. Barrows and his friendly staff. He has been my dermatologist since 1999 and did very good work on my skin cancers on my nose....no plastic surgery needed!"- J.J. / Google / Jun 02, 2016
"I had a bad skin cancer removed off my neck yesterday by Dr Barrows, 4cm x 6cm, down to the muscle..GREAT staff, GREAT Dr's..we had a blast while the Dr was doing the procedure..I won't go anywhere else now"- R.M. / Facebook / Apr 21, 2017
What to Expect
Compared to other skin cancer treatments, Mohs is significantly more labor intensive and can require more than one physician to successfully perform the surgery. A patient might encounter up to 4 doctors during the surgery, including a surgeon, histotechnician, pathologist and a reconstructive or plastic surgeon. Since anesthesia is used, most patients experience little pain during surgery but may feel mild discomfort. As an outpatient surgery, Mohs is usually performed in a doctor’s office but occasionally it’ll be performed in an outpatient surgical center. The entire process usually takes several hours depending on the complexity or size of the cancer.
After surgery, most patients experience little pain so medication usually isn’t required. If there’s pain associated with the surgery, a doctor will normally advise an over-the-counter painkiller. While the majority of patients are able to return to normal activities by the next day, patients must refrain from taking part in strenuous exercise for 1-3 weeks. If the wound was stitched, a doctor will remove the stitches anywhere from 4 to 14 days after surgery. Since cancer is removed layer-by-layer, micrographic surgery provides a high cure rate as well as preserving surrounding healthy skin, but there’s always a potential for scarring. It’s unlikely that cancer will recur after this surgery. When treating primary basal cell carcinoma, the success rate is 97%-99%. Squamous cell carcinoma has a cure rate of around 94%. Treating melanoma-in-situ is heavily dependent upon the skill of the surgeon and the success rate can range anywhere from 75% to 95%.
Schedule Your Consult
For any skin cancer patient considering Mohs Micrographic surgery as a treatment option, it is extremely important to find the right doctor. The success rate of this surgery is highly connected to the skill and care of the doctor performing it. During a consultation, a patient should ask pertinent questions such as the doctor’s experience, training and personal success rate as well as the risks and complications involved and post-op treatment. Together, the doctor and patient can map out the best course of treatment to successfully treat the patient’s cancer. Call our highly trained professionals today to schedule a consultation.