Mohs Surgery has withstood the test of time, remaining the gold standard and best way to treat certain types of basal cell and squamous cell skin cancers. Mohs—developed by general surgeon, Frederic E. Mohs—is a microscopically controlled surgery used to treat common types of skin cancer. During Mohs surgery, the surgeon can see where the cancer stops.
This ability gives the Mohs surgeon two important advantages:
- Mohs surgery has a high cure rate
- Surgery allows you to keep as much healthy skin/healthy tissue as possible because the surgeon only removes the skin with cancer cells
Mohs Surgery to Remove Skin Cancer – Omaha, NE
Basal cell carcinoma and squamous cell carcinoma skin cancers (referred to as nonmelanoma skin cancers) are incredibly common types of skin cancer. With more than 3 million cases per year in the US alone! Often it is possible to treat skin cancer with simple surgical techniques or even medication at times.
The best news is that it’s rare for nonmelanoma skin cancers to spread (metastasize). However, they can grow quite large and destroy surrounding tissues. Some types of nonmelanoma skin cancers can be particularly hard to remove. These include:
- ones that have come back after previous treatments
- areas that have higher rates of aggressive growth (like the head and neck)
- others with especially aggressive microscopic features
For these particular basal and squamous cell skin cancers, Mohs surgery is often the ideal treatment option because with its microscopically-driven stages of cancer removal the highest cure rates possible are achieved.
Standard Removal of Skin Cancer – Excision
A standard removal of skin cancer is called an excision. With the excision technique, the removed piece of skin is processed overnight, and the margins are examined by what is called “breadloafing.”
In breadloafing, the margins on that piece of skin are microscopically analyzed at intervals along the original specimen. These are slices through the specimen, just like you’d slice a loaf of bread. Though this treatment is sufficient for many skin cancers—for ones in higher risk circumstances noted above, we worry ABOUT THE SPACES BETWEEN THE SLICES.
Mohs Surgery to Remove Skin Cancer
In higher-risk skin cancers, Mohs Surgery comes into importance. With Mohs, the microscope is king. Before the removal of skin, your Mohs surgeon will use a local anesthetic to numb the area thoroughly. The Mohs surgery technique is a state-of-the-art treatment that involves surgically removing the skin cancer and a small amount of normal surrounding skin.
Although the Mohs procedure typically takes place in an outpatient setting, in cases that require more extensive reconstruction, Mohs surgery will be performed in an operating room under general anesthesia or sedation. By using special rapid processing techniques, a dermatologist can examine 100% of the edges of the specimen that very same day.
In Mohs Micrographic surgery, the dermatological surgeon acts as both the surgeon and the pathologist by both removing the skin cancer and examining it microscopically. In stages, the Mohs surgeon can identify areas that still contain cancer, map these out on a diagram, and destroy any remaining cancer by removing more skin where necessary – repeating the process until a patient is free of cancer.
Reconstruction After Mohs Surgery
Reconstructive surgery may be necessary after Mohs surgery, but not always. If there is a large defect in a visible or sensitive area, such as the nose or areas around the eyes or ears, skin grafts or local flaps may be used. More extensive reconstruction may require coordination with a plastic surgeon, and the type of reconstructive surgery needed will be determined during a consultation with the Mohs surgeon.
Learn more about Moh’s Micrographic Surgery:
Advanced Dermatology of the Midlands Omaha, NE & Council Bluffs, IA – Mohs Surgery
At Advanced Dermatology of the Midlands, we perform Mohs surgery to remove skin cancer on a near daily basis. Monday through Friday. We utilize our state of the art CLIA-certified laboratory to prepare and examine high-risk skin cancer specimens during the Mohs surgery procedure. In addition to being board-certified dermatologists, both Dr. Mathew Davey and Dr. James Shehan are fellows of the American Society for Mohs Surgery. Through the education and certification of this organization they are highly trained in the techniques of Mohs micrographic surgery. Collectively they have more than 20 years total experience performing this procedure.
Though their diligence in performing the surgery in a precise and meticulous way is extremely important to them, the overall patient experience is equally as important. We recognize that two of the greatest challenges for patients can be:
- discomfort from the procedure
- the time it takes to wait as specimens are processed
Because of this, we have implemented several different techniques to reduce patient discomfort with local anesthesia which have been successful in our practice. As far as the time in waiting goes, we have both cable television and Wi-Fi available in all our surgery rooms. These things help the time pass much more smoothly for all our patients while Mohs surgery specimens are processed.
If you have spots that are worrisome for skin cancer or questions about whether Mohs surgery is right for you, we would be happy to help at Advanced Dermatology of the Midlands located in Omaha, NE, and Council Bluffs, IA.
For any information or to make an appointment please contact us today.