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.
Will Mohs Surgery Leave A Scar?
Yes, a small scar will be left after Mohs surgery.
How long does it take for a wound to heal after Mohs surgery?
Recovery time will depend on the size of the wound but it is not uncommon for these wounds to take about 4-6 to fully heal.
Is Mohs Surgery The Best Treatment Option For All Skin Cancers?
Mohs surgery is a great treatment option because it has the lowest recurrence rates (when the cancer comes back) and highest cure rates. It is especially helpful at treating basic cell and squamous cell carcinomas.
What can you not do after Mohs surgery?
For the first week after surgery, avoid heavy lifting, exercise, and bending.
What is the fastest way to recover from Mohs surgery?
The fastest way to recover is by keeping your wound clean and following your doctor’s aftercare guidelines.
Does Mohs surgery leave a hole?
Mohs surgery will leave a hole that is usually closed with stitches. Sometimes, if the removed spot is very small, the hole will be covered with a bandage and left to heal on its own.
What should I do to prepare for Mohs Surgery?
Before your surgery, make sure to discuss your allergies and medications with you doctor. You should also stop smoking and drinking prior to the procedure. Since you will be awake during the surgery, wear comfortable clothes that you can relax in and bring something to occupy yourself during waiting periods.
How long does the Mohs procedure take?
The Mohs procedure will take about 3-4 hours.
Can you drink alcohol after Mohs surgery?
Since alcohol can increase the risk of bleeding, it is recommended you do not drink for at least 24 hours after surgery
Can you shower after Mohs surgery?
It is important to keep your bandages completely dry for 24 hours, so it is recommended that you wait until after this time period to take a shower.