Mohs Surgery: A Highly Effective Skin Cancer Treatment

February 2024

Here’s What You Need to Know About Mohs Micrographic Surgery for Skin Cancer

Mohs surgery is considered to be the most effective technique for treating skin cancer and has been shown to result in cure rates of up to 99% in skin cancer patients. We’re proud to offer this surgery to our patients at two Optima Dermatology locations. If you have been diagnosed with skin cancer, Mohs surgery can be a great option. Providing Mohs surgery uniquely allows Optima Dermatology to deliver a full scope of skin cancer treatment in-house, making the treatment process easier for our patients.

Our board-certified micrographic dermatological surgeons, Dr. Brienne Cressey, who serves patients at our Stratham, NH practice, and Dr. Sherry Yu, who serves patients at our Macedonia, OH practice, have provided answers to the most frequently asked questions our patients have about Mohs surgery. Here’s what you need to know about this skin cancer treatment to help inform you of your options and how this approach can help.

Mohs Micrographic Surgery FAQs

Q: What is Mohs Micrographic Surgery and how does it work?

A: The Mohs procedure involves surgically removing skin cancer layer by layer and examining the tissue under a microscope until healthy, cancer-free tissue around the tumor is reached. This process allows the removal of all cancerous cells for the highest cure rate while sparing healthy tissue and leaving the smallest possible scar.

Mohs micrographic surgery is the gold standard for the treatment of skin cancers on cosmetically sensitive areas such as the face, areas with limited tissue mobility for wound closure like the hands/feet/scalp or shins, and for aggressive or recurrent skin cancers.

Q: When speaking to patients about Mohs surgery, how is the process explained?

In excisions, the tissue is sent to pathology, and slices are reviewed, similar to slices of bread. A larger skin margin is needed since the entire border is not evaluated.

However, Mohs surgery removes and processes skin cancer with a small healthy tissue margin. A helpful comparison is to think of it as a pie crust and pie filling. The pie filling is the tumor and the healthy tissue margin is the pie crust.

We remove a narrow healthy tissue margin around the skin cancer and examine the entire peripheral margin and deep margin (pie crust). If any skin cancer is identified, we take an additional margin of skin in that area. Once the “pie crust” is 100% clear, we know the tumor has been removed. This process provides the highest cure rate.

Q: When would a dermatologist recommend Mohs surgery over other skin cancer treatment options?

Mohs surgery is most often recommended for skin cancers on the face, neck, hands, and feet where it is most important to spare as much normal skin tissue as possible. It is also ideal for situations where tumors may be large, aggressive, or recurrent.

Q: What are the advantages of Mohs surgery for skin cancer removal?

Because the entire skin margin is evaluated, Mohs surgery conserves tissue as it requires a smaller margin of normal tissue compared to standard excisions. There is precise microscopic control of the entire tumor margin and as a result, Mohs surgery is the most highly effective approach to skin cancer treatment.

By maintaining skin tissue, Mohs surgery helps cure patients while protecting the areas of their skin that require treatment.

Q: What can patients expect from Mohs surgery?

Patients should expect to be at our office for several hours on the day of surgery. After surgery, they will go home with a large bandage and likely have some restrictions in activity for several days to several weeks.

Mohs surgery is performed using a local anesthetic to numb the area. We talk to each patient during the procedure so you are aware of what is going on. Once clear skin margins are obtained, the area is often sutured to provide the best cosmetic outcome possible.

Next, we asked each of our Mohs surgeons a little bit about their career paths and backgrounds. Exception patient care is at the core of what we do at Optima Dermatology, and our surgeons are truly experts in their field.

Q: What type of education and training is required to become a Mohs surgeon, and what led you to choose this particular career path?

Dr. Sherry Yu: I earned my medical degree from Case Western Reserve University in Cleveland, Ohio. I completed my residency in dermatology through the Harvard Combined Dermatology Residency Training Program and a fellowship in Mohs micrographic surgery and dermatologic oncology at Yale University School of Medicine.

I have always liked the balance of medicine and surgery in dermatology and, more specifically, Mohs surgery. Additionally, much of my academic research has focused on how medical conditions affect quality of life and how many chronic skin diseases have been shown to have a significant impact on patients.

Dr. Brienne Cressey: I studied Biochemistry and Chemistry at The University of Maine. I then went to Tufts University for medical school where I received my MD and MBA, followed by my internship at Memorial Sloan Kettering Cancer Center and a dermatology residency at New York Presbyterian-Weill Cornell in New York City.

I then continued to be a Dermatologic Oncology Fellow at Dermatology Professionals in Rhode Island, working under Dr. Nathaniel Jellinek to complete my Fellowship in Mohs Micrographic Surgery, facial reconstruction, and lasers and cosmetics.

I have always enjoyed the complexity of dermatology and the procedural aspect of the field. I’m able to combine Mohs surgery with my favorite aspects of medicine to deliver the most impactful and well-rounded patient care.

Q: Do you work with dermatologists outside of Optima Dermatology, and what do those relationships look like?

We do – and we are very grateful for our outside referring dermatologists and their patients. We strive to keep your dermatologist in the loop and will send them information when you have scheduled your appointment and again when you have had your surgery. After surgery, you will return to your dermatologist for regularly scheduled follow-ups.

We work with dermatologists at the VA, other dermatology practices, and primary care practices in the area. Our offices receive biopsy pathologies and referrals. Once this information is received, our team will contact you to review the Mohs procedure, discuss your expectations and concerns, answer any questions, and schedule your appointment.

Optima Dermatology offers Mohs surgery at our Stratham, NH, and Macedonia, OH locations. You can call us at (855) 277- 9689 to learn more!