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What is Mohs micrographic surgery?
Mohs Surgery is a highly specialized surgical technique for the precise removal of skin cancer. This method uses microscopic evaluation of the complete tissue margin to ensure that all the skin cancer is removed prior to reconstruction.
The procedure involves removing one thin layer of tissue at a time. After each layer is removed, the tissue is carefully examined under the microscope. The Mohs surgeon is able pinpoint areas of skin cancer that may be invisible to the naked eye and spare as much healthy tissue as possible. This accounts for the very high cure rate with Mohs surgery and allows the surgeon to keep the scar as small as possible.
What happens on the day of surgery?
Why choose a fellowship-trained Mohs surgeon?
When you arrive, the staff will escort you to your surgical room for evaluation. Dr. Krausz will mark out the site and anesthetize the area, similar to what you had done for the skin biopsy. Once the area is fully numb, Dr. Krausz will remove all visible portions of the skin cancer and a narrow margin of normal-appearing skin. The removed tissue is mapped and brought to the adjacent laboratory for frozen-section processing.
While the slides are processed, a temporary bandage will be placed over the wound. We encourage you to bring reading material and snacks for the down-time! If skin cancer is found extending beyond the excised margins, another thin layer of tissue will be removed. Most skin cancers are removed in one or two stages, but there is no way to predict prior to surgery if the roots of the skin cancer extend widely.
Once the skin cancer is removed, the wound will either be reconstructed linearly or with a flap or graft or allowed to heal naturally. The decision is based on what will cause the least amount of pain and leave the smallest scar possible.
For more information on Mohs surgery, click here.
The American College of Mohs Surgery (ACMS) was established by Dr. Frederic Mohs himself, the physician who developed the Mohs surgery technique. Fellowship training programs through the ACMS provide rigorous training in dermatologic oncology, micrographic surgery and advanced reconstruction. Participants who are selected for ACMS- approved fellowships undergo an additional 1-2 years of training after dermatology residency.
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