What is Mohs Micrographic Surgery

Mohs micrographic surgery is a specialized, highly effective technique for the removal of skin cancer. The procedure was developed in the 1930s by Dr. Frederic Mohs at the University of Wisconsin and is now practiced throughout the world. Mohs surgery differs from other skin cancer treatments in that it permits the immediate and complete microscopic examination of the removed cancerous tissue, so that all “roots” and extensions of the cancer can be eliminated. Due to the methodical manner in which tissue is removed and examined, Mohs surgery has been recognized as the skin cancer treatment with the highest reported cure rate.

Special Qualifications of the Mohs Surgeon

Physicians performing Mohs surgery should have specialized skills in dermatology, dermatologic surgery, dermatopathology, and Mohs surgery. Basic and advanced training in Mohs surgery is available through selected Residency programs, specialized fellowships, observational preceptorships, and intensive training courses. In addition, the Mohs surgeon must have the required surgical and laboratory facilities and must be supported by a well-trained Mohs nursing and histotechnological staff. Your Mohs surgeon can provide you with detailed information regarding his or her training in the above disciplines, as well as all applicable professional affiliations.

Advantages of the Mohs Surgical Procedure

Some skin cancers can be deceptively large – far more extensive under the skin than they appear to be from the surface. These cancers may have “roots” in the skin, or along blood vessels, nerves, or cartilage. Skin cancers that have recurred following previous treatment may send our extensions deep under the scar tissue that has formed at the site. Mohs surgery is specifically designed to remove these cancers by tracking and removing these cancerous “roots” For this reason, prior to Mohs surgery it is impossible to predict precisely how much skin will have to be removed. The final surgical defect could be only slightly larger than the initial skin cancer, but occasionally the removal of deep “root” of a skin cancer results in a sizeable defect. The patient should bear in mind, however, that Mohs surgery removes only the cancerous tissue, while the normal tissue is spared.

Insurance Coverage for Mohs Surgery

Most insurance policies cover the costs of Mohs surgery and the reconstruction of the resultant surgical area. Please contact your insurance carrier directly for the most current payment information relative to this surgery. The insurance billing department in your Mohs surgeon’s office also may be able to assist you.

It is important that you obtain a good night’s rest and eat normally on the day of your surgery. For your comfort, it is recommended that you wear casual, layered clothing. You may also wish to bring a light snack and a book or magazine to help occupy your waiting time. Also, it may be advisable to arrange for someone to drive you home following surgery, if needed.

Duration of Procedure

Most Mohs cases can be completed in three or fewer stages, requiring less than four hours. However, it is not possible to predict how extensive a cancer will be, as the extent of the skin cancer’s “roots” cannot be estimated in advance. Therefore, it is advisable to reserve the entire day for this surgical procedure, in case the removal of additional layers is required

Minor Post-Surgical Discomfort Expected  

Most patients do not complain of significant pain. If there is some discomfort, normally only Tyenol is required for relief. However, stronger pain medications are available and will be prescribed when needed. You may experience some bruising and swelling around the wound, especially if surgery is performed near the eye area.