Mohs micrographic surgery is highly recommended for removing the 2 most common types of skin cancer, basal cell carcinoma and squamous cell carcinoma. The surgery is especially effective for difficult cases, such as when the cancer is large or aggressive, and when it’s in an area like the nose or ear. This surgery may be considered for treating melanoma, but only when it’s diagnosed in an early stage. It’s also used to treat several types of rare skin cancer.
The most important benefit of Mohs surgery is that the procedure removes all of the cancer while leaving the surrounding healthy tissue intact and unharmed. After the visible part of the cancer is removed, Dr. Marshall begins taking tissue one thin layer at a time. Each time a layer is removed, it’s immediately placed under a microscope, where the tissue is examined to see if it contains any cancer. If cancer is present, the doctor takes the next layer of skin and it’s examined under the microscope. When tissue that’s removed is free of cancer, all of the cancer has been excised, and the surgery can stop.
After the cancer is gone, Dr. Marshall knows the extent of the wound and can talk with you about reconstruction. If the area is small, it may heal on its own or need a few stitches. If a larger area of tissue was removed, he can graft a piece of skin over the wound, either using skin that’s available near the surgical site, or by removing skin from another part of your body.
After the procedure, you’ll need a little time to rest and recover, but since Mohs surgery only requires a local anesthetic, it doesn’t take long before you’ll be ready to go home. You may feel mild discomfort or have some bleeding, redness or inflammation, which is only temporary and is treated with bandages and topical ointments. Dr. Marshall will let you know if you need to restrict activity for a while, give you complete care instructions, and answer your questions before you leave the office.
If the wound that remains after surgery is deep or extensive, you’ll need reconstructive surgery to regain your normal appearance. You don’t have to decide about when to schedule surgery right away, but in most cases you can get it done as soon as you’re ready.