MOHS Surgery

If you are diagnosed with squamous cell carcinoma or basal cell carcinoma, you have a few treatment options. At Silver Falls Dermatology, our expert providers often recommend Mohs surgery. This surgical technique is a more precise option compared to traditional excision. Mohs surgery also allows surgeons to preserve as much healthy tissue as possible while effectively removing cancerous skin cells. If you are located in Oregon or Washington and suspect you may have skin cancer, schedule an appointment at Silver Falls Dermatology. 

What is Mohs Surgery?

Mohs Micrographic Surgery is a specialized, highly effective technique used in the removal of certain types of skin cancer. The procedure is different from other skin cancer treatments, as it allows the entire examination and removal of the cancerous tissue to be completed in one visit. As a result of this expedient process, as well as the methodical removal and examination of the tissue, Mohs surgery as a treatment for skin cancer has been recognized as having the highest reported cure rate.

Candidates for Mohs Surgery 

Mohs surgery is an appropriate treatment option for most patients with squamous cell carcinoma or basal cell carcinoma. These are the two most common types of skin cancer. In particular, Mohs surgery is useful for skin cancers that have a high risk or history of recurrence, have borders that are difficult to define or identify, are aggressive or large or are located in sensitive or highly visible areas such as the face, hands or genitals. 

The Mohs Surgery Procedure 

To prepare for surgery, take your medications as normal and have a light breakfast/lunch before coming to the appointment (unless you are specifically told to fast). Since these surgeries can take a while and a lot of the time involves waiting, it may be a good idea to bring a book or magazine. We will have coffee, drinks, and snacks available as well.

Mohs surgery is a controlled, precise process. Prior to entering surgery, it’s impossible to know the amount of skin that will have to be removed, as some cancers can extend “roots” further under the skin than may be seen from the surface. It’s for this reason that the precise method of Mohs surgery of tracking and removing these “roots” is the preferred method. With Mohs, only the cancerous tissue is removed, while the normal tissue is preserved. In Mohs surgery, thin layers of the cancerous tissues are removed and examined individually as the patient waits. This allows surgeons to remove as much cancerous tissue as possible while reserving as much healthy tissue as possible. Only a very small margin of surrounding healthy tissue is removed through a Mohs surgery. 

Mohs surgery and resulting reconstruction is completed in our office under local anesthetic. The procedure can take between two hours and four hours, depending on the number of cancers removed, the size of tumor, and how many layers are removed from each spot. Rarely, the surgery can take an entire day.

After Mohs Surgery 

Repairing the wound after Mohs surgery will vary depending on the size of the area. In some cases, stitches may be necessary to close the wound. Your surgeon may also suggest options such as using a skin flap or skin graft to cover larger wounds. For smaller areas, simply bandaging the area and allowing the skin to heal naturally may be sufficient. Your surgeon will explain your best option and give you specific instructions regarding cleansing and otherwise caring for the area. You can expect some redness, swelling and tenderness as the wound heals. These symptoms should resolve within a week or two of the surgery. 

After Mohs surgery, you will schedule routine follow-up appointments. This is important as there is a small risk of skin cancer recurrence. Your provider will explain signs of skin cancer to look out for at home. Most patients will require professional skin exams once or twice per year.