Mohs Surgery

What is Mohs Surgery?

Our leading Mohs surgeons are highly skilled and trained in removing and curing skin cancer, utilizing a technique known as Mohs Micrographic Surgery (aka Mohs Surgery). Mohs surgery is considered the most effective technique for treating skin cancer, with cure rates of up to 99%. Mohs can be used to treat basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs)--the two most common types of skin cancer--and to treat Melanoma (the deadliest form of skin cancer), utilizing advanced training and techniques by Optima surgeons. 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 allows the removal of all cancerous cells for the highest cure rate while sparing healthy tissue and leaving the smallest possible scar.

The Mohs Process

Mohs surgery is performed in the following steps:

After local anesthesia, the first step is to remove the visible portion of the tumor. This process is called “debulking” the tumor. Any visible tumor is debulked and discarded, preparing the site for the Mohs layer.
Then a thin layer of tissue is surgically excised under and around the debulked defect. This Mohs layer is generally only 1-2mm larger than the clinical tumor.
Next, the Mohs layer is precisely mapped and processed in a unique manner and examined under the microscope. Our Mohs surgeons examine 100% of the bottom surface and outside edges of the Mohs layer on the microscopic slides.
If any tumor is seen during the microscopic examination, its location is marked on the map and a thin layer of additional tissue is excised from the precise area involved. The microscopic examination is then repeated. The entire process is continued until no tumor is found and is completed in one visit.

Reconstruction

After the skin cancer has been completely removed, a decision is made on the best method for treating the wound created by the surgery. These methods include letting the wound heal by itself, closing the wound in a side-to-side fashion with stitches, or closing the wound with a skin flap or graft. The best method is determined on an individual basis. All wound repairs are performed immediately while the site is still anesthetized. All of our Mohs surgeons have undergone extensive specialized reconstructive surgery training for repairing the wound. On a rare occurrence, other surgical specialists may be utilized for their unique skills if warranted.

Mohs vs. Superficial Radiation Therapy (SRT)

Benefits of Mohs:

• The most effective skin cancer treatment – over 99% cure rate
• Only removes skin cancer and preserves healthy skin
• Superior long-term cosmetic outcomes
• Cost effective

Our top priority is to provide the most effective skin cancer treatment available for each patient. Image-guided SRT, an X-ray based treatment, has been promoted to patients in recent years as a Mohs surgery alternative. However, SRT has inferior long-term cure rates, requires multiple treatment visits (sometimes as many as 20 to 30), is higher cost for the patient, and has limited published literature on its side effects and long-term consequences. National expert consensus entities firmly state that image-guided SRT should only be considered as a second-line treatment option under special circumstances for patients who are non-surgical candidates.

We are committed to providing patients with transparent information about their treatment options. Please click the button below for a helpful breakdown that compares Mohs and SRT and please reach out to our practice with any questions or concerns.

Comparing Mohs & SRT

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