Mohs Surgery

What is Mohs Surgery?

Mohs micrographic surgery is a specialized technique for the removal of skin cancer that has the highest reported cure rate. Unlike other skin cancer treatments, it allows us to examine the entire margin of skin we are removing. Because we are taking as small a margin as possible, the cosmetic outcome may be better than a regular surgery.

Advantages of Mohs Surgery

Some skin cancers can be deceptively large, extending far further under the skin than they appear to be at the surface. These cancers may have “roots” which are carefully tracked and removed during the procedure. Mohs surgery is not for all cancers. It is typically reserved for cancers on the face, scalp, genital area, hands, feet, shins and recurrent or large in many locations.

What happens during the procedure?

1)       You are awake for the entire procedure. The cancer is identified and the area marked and cleansed. Minimal discomfort is felt when the area is anesthetized, or numbed. Dr. Ladrigan will remove the visible cancer along with a thin layer of additional tissue (Stage I).

2)       The tissue is taken to our lab and processed for examination under the microscope. This processing can take an average of 2 hours, longer if the specimen is larger.  Dr. Ladrigan will examine the entire undersurface and complete edges of the specimen.

3)       If any microscopic “roots” are identified, Dr. Ladrigan will remove additional tissue (Stage II) only where cancer is present. The process is repeated as many times as needed to locate any remaining cancerous areas (Stage III, Stage IV, etc.).

4)       When microscopic examination reveals that there is no longer any cancer, the area is ready to be repaired. On average, patients will have one to two stages before closure.

Should I see a Plastic Surgeon?

Mohs Surgeons and Plastic Surgeons both train in advanced closure techniques. Plastic Surgeons are not able to microscopically examine the tissue to make sure the tumor is clear. Certain patients may need a Plastic Surgeon after Mohs, for more complex repairs, however this would be arranged prior to your appointment.