Mohs

Mohs surgery is a precise surgical technique used to treat skin cancer. During Mohs surgery, thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains. Mohs surgery is also known as Mohs micrographic surgery.

The goal of Mohs surgery is to remove as much of the skin cancer as possible, while doing minimal damage to surrounding healthy tissue. Mohs surgery is usually done on an outpatient basis using a local anesthetic.

Mohs surgery is an improvement to standard surgery (local excision), which removes the visible cancer and a small margin of healthy tissue all at once. Mohs surgery allows surgeons to verify that all cancer cells have been removed at the time of surgery. This increases the chance of a cure and reduces the need for additional treatments or additional surgery.

Procedure

Mohs surgery is done in stages, all in one visit, while the patient waits between each stage. After removing a layer of tissue, the surgeon examines it under a microscope in an on-site lab. If any cancer cells remain, the surgeon knows the exact area where they are and removes another layer of tissue from that precise location, while sparing as much healthy tissue as possible. The process is repeated until no cancer cells remain.

Uses

Mohs surgery is used to treat the most common skin cancers, basal cell carcinoma and squamous cell carcinoma, as well as some kinds of melanoma and other types of cancer. Mohs is also recommended for skin cancers that:

• Have a high risk of recurrence or that have recurred after previous treatment
• Are located in areas where preserving cosmetic appearance and function are important
• Are large or aggressive
• Have edges that are hard to define

Risks

As with any surgical procedure, Mohs surgery carries the risk of infection and bleeding. Other risks associated with Mohs surgery might include:

• Temporary or permanent numbness
• Temporary or permanent weakness or twitching of the muscles
• Itching or shooting pain in the area of surgery
• Enlarged scar (keloid)

Preparation

Before Mohs surgery, your doctor will likely recommend preparing for the possibility of a long day. The procedure involves waiting while tissue is examined. You might want to bring a book or other forms of entertainment.

Recovery

After Mohs surgery, you might need a simple wound closure, stitches or a skin graft depending on the size of the removed tissue. You'll likely be able to return to normal activities the day after surgery.

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