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What is MOHS Micrographic Surgery?
MOHS micrographic surgery is a specialized, highly effective surgical technique for the removal of certain skin cancers on certain areas of the body. The procedure was developed in the 1930's by Dr. Frederic Mohs, and is practiced by dermatology surgeons who have undergon dermatology residencies and specialized fellowship programs.
MOHS surgeons have proper on site laboratory facilities and staff specially trained to prepare the tissue slides that the surgeon examines for each patient.
Special Indications for MOHS Surgery:
MOHS micrographic surgery is appropriate for the treatment of most types of skin cancers. MOHS surgery is especially suited for cancers of the face and scalp, as well as sites where skin cancer was previously found and surgically removed.
Advantages of the MOHS Surgical Procedure:
This form of treatment has the highest cure rate (96-99%) of any type of skin cancer removal procedure. MOHS surgery also preserves the maximum amount of healthy surrounding skin tissue for both cosmetic reasons as well as functional purposes. This includes the goal of preserving a very natural appearance of the nose, lips, ears as well as around the delicate tissue of the eyelids and allowing for the normal ability to open and close the eyes and mouth.
Some skin cancers can be very deceptive in size, and in reality may extend far under the surface of the skin than appears to the eye. These cancers may have "roots" under the skin that send out extensions along nerves, blood vessels or bony cartilage. What might appear to be a pencil-eraser sized spot may actually extend outward and downward deeply beneath the skin as well. MOHS surgery is specifically designed to remove these cancers by tracking and removing the "roots", while sparing the normal skin around the cancer.
It is impossible to predict precisely how much skin will have to be removed. The final surgical site may only be slightly larger than the visible skin cancer, or it may be significantly larger or deeper.
The MOHS Surgical Procedure:
The area to be treated is cleansed, marked and injected with a local anesthetic. Dr. Beer will then remove the visible cancer, along with a thin margin of surrounding skin tissue. This procedure takes only a few minutes~ A temporary dressing is then applied and you will be guided to a post-operative waiting room to relax while the slides are prepared. The slide preparation time will take at least 45 minutes, during which Dr. Beer will carefully examine the entire skin tissue under a microscope. If any residual cancer is found within the skin tissue removed, you will be guided back to your room, and Dr. Beer will remove additional tissue only in the area where cancer is still present.
This procedure may be repeated several times during your visit, depending on how deep or wide the cancer remains. Most patients are "cleared" within 1-2 tissue removals or stages. When the site is free of cancer, Dr. Beer will repair the skin. Usually the entire procedure lasts 3-4 hours.
Insurance coverage for MOHS:
Most insurance policies cover all or part of the costs of MOHS surgery and the repair of the skin site as well. You may need a prior authorization. If you have any questions, please contact your insurance.
Robert Beer M.D.
Fellow of the American College Mohs Micrographic Surgery and Cutaneous Oncology