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Mohs Micrographic Surgery

Dr. Frederic Mohs developed Mohs surgery in the 1930s and the procedure has been refined and updated for modern use. Dr. Mohs realized that skin cancer is like the “tip of the iceberg” and that what we see is only the outward manifestation, but that the cancer grows into the skin like the roots of a tree and is only visible with microscopic analysis. Mohs surgery is considered to be the most effective and least invasive treatment for many nonmelanoma skin cancers because it gets to and removes the roots.  It is also better than most other conventional treatments for melanoma.

What is Mohs surgery?

Mohs surgery is a highly specialized and precise treatment for nonmelanoma skin cancers and has a 99% cure rate for skin cancers that have not been treated before; and a 94% cure rate for nonmelanoma skin cancers that have received previous treatments. The high success rate is due to the fact that the excised tissue is examined by the surgeon, under a microscope during surgery, and not after the tumor has been removed.

How is Mohs surgery performed?

Mohs surgery is a precise procedure that it is performed by Dr. Christopher Crosby. He has advanced training which is required because he must act as both a surgeon and a pathologist. Mohs is performed in Dr. Crosby’s office, under local anesthesia. The procedure is performed in stages.  It usually takes about an hour to remove a tissue sample and examine it for cancer cells. The procedure is completed in one day.

The area to be treated is numbed, and the lesion is removed one layer at a time. Dr. Crosby examines each layer under a microscope on site, to identify and map the microscopic roots of the cancer. If cancer cells remain, Dr. Crosby knows exactly where those cells are. If needed, he can inject more anesthesia, and then remove another layer. The entire procedure is repeated until no cancer cells remain. The length of surgery depends upon the size, location, and depth of the tumor.

The next step is cosmetic wound repair designed to ensure limited scarring. Patients will go home knowing the cancer is completely gone. Scars will improve with time. After the surgery you will wear a bandage until the sutures are removed 7-10 days later.

Side effects include swelling, bruising, tenderness, and tightness at the site while the tissue heals. This is normal and temporary. Risks are the same as with any surgical procedure.

When is Mohs surgery recommended?

This highly technical surgery is usually reserved for certain circumstances, specifically:

  • To remove nonmelanoma skin cancer, and especially scarring Basal cell carcinomas that are in cosmetically sensitive areas, near important features; and to preserve healthy tissue for the best aesthetic and functional outcome. Cosmetically sensitive areas include the face, nose, lips, eyelids, ears, fingers, toes, and genitals.
  • When the tumor is large and has indistinct margins.
  • When there is a high risk of recurrence.
  • To remove a recurrent skin cancer.
  • When the tumor is located near scar tissue.
  • When the tumor is aggressive and fast growing.

What are the advantages of Mohs surgery?

The major advantage of Mohs surgery is that the process ensures that 100% of tumor is removed and the maximum amount of healthy tissue is preserved which provides the best cosmetic result.

Protect your skin!

Anyone who has had skin cancer is at risk of getting it again. Patients should see a dermatologist once or twice per year for a skin check. Approximately 20% of individuals who have had skin cancer may experience a recurrence or new growth after the original diagnosis. It is important to regularly check the skin.

Whether for work or for play, your active lifestyle may keep you out in the sun regularly or for long hours. Protect your skin at all times. Even on cloudy days, the sun’s rays can be damaging. Sunscreen should be worn daily on any exposed skin regardless of the weather. Constant exposure to ultraviolet light leads to more damage and aging skin.

Contact Coastal Skin and Eye Institute in San Diego, CA to learn more about our treatments for skin cancer. Call (858) 943-2540. We serve patients in San Diego and surrounding communities.

Coastal Skin & Eye Institute/Grossmont Dermatology