Mohs Surgery

Mohs micrographic surgery is a minor, yet advanced surgical procedure that removes squamous cell and basal cell carcinoma skin cancers effectively using only local anesthesia.  Mohs surgery has a 99% cure rate, making it the most exact and precise method of tumor removal. It minimizes the chance of regrowth and lessens the potential for scarring or disfigurement.

This state-of-the art treatment entails sequentially removing small layers of skin and immediate examination by the mohs surgeon under a microscope until the samples indicate that the skin cancer is completely gone. By removing only tissue where skin cancer is present, the technique allows for a very high cure rate with good preservation of normal skin. Dr. McDaniel will perform the Mohs skin cancer surgery in the office.  When your tumor is removed, Dr. McDaniel will assess the wound and discusses options for reconstruction. This will most likely involve suturing the area to optimize the cosmetic result. Dr. McDaniel’s experience in surgical reconstruction enhances her ability to give patients the best possible cosmetic, post-operative result. She serves as a surgeon, pathologist, and reconstructive surgeon for complete integration of care. 

What skin cancers are treated with Mohs surgery?

There are several different types of tumor growth that are best treated using the Mohs technique, most commonly melanoma, basal cell and squamous cell carcinomas. What is visible on the surface of the skin may only be a portion of the tumor that exists beneath.

The history of Mohs surgery

Mohs surgery, also known as Mohs micrographic surgery, was named after Dr. Frederic Mohs. Dr. Mohs developed the technique at the University of Wisconsin in the 1930’s. Mohs micrographic surgery has since been refined into the most advanced, precise, and effective treatment for an increasing variety of skin cancer types.

What to expect during Mohs surgery?

If you have Mohs surgery, you’ll see Dr. McDaniel, a trained Mohs surgeon. Dr. McDaniel is a board-certified dermatologists who has completed extensive training in Mohs surgery.

During Mohs surgery, patients remain awake and alert. This means Mohs can safely be performed in our medical office or surgical suite. On the day of the surgery, Dr. McDaniel will first examine the area to be treated. You’ll then be prepped for surgery by injection of a local anesthetic. This injection only numbs the area that will be operated on, so you’ll be awake during the surgery.

Once the anesthetic takes effect, the surgery can begin. Dr. McDaniel starts by first cutting out the visible skin cancer. Next, she will removes a thin layer of surrounding skin. You are then bandaged so that you can wait comfortably.

While you wait, Dr. McDaniel will look at the removed skin under a microscope. She is looking for cancer cells. If cancer cells are found, you’ll need another layer of skin removed.

Once cancer cells are no longer seen, Dr. McDaniel will decide whether to treat your wound. Some wounds heal nicely without stitches. Others need stitches. To minimize the scar and help the area heal, some patients require a skin graft or other type of surgery.

If you need wound treatment, Dr. McDaniel may treat the wound that same day. Dr. McDaniel is trained to remove the cancer, read the pathology and to reconstruct the wound left from cancer removal such that our patients receive full services care. This extensive training is impressive, but the most notable fact is that Mohs surgery has a success rate of up to 99% for treating skin cancers!

Who is Mohs recommended for? 

No matter what type of skin cancer you have, Mohs is only recommended for certain patients. The AAD and ASMS recommends Mohs surgery on skin cancers that:

  • Develop on cosmetically sensitive areas (i.e. face)
  • Are located in scar tissue
  • Are large and/or have ill-defined borders
  • Develop on areas that need to retain function (i.e. eyelids)
  • Have recurred after previous treatment or are likely to recur
  • Grow rapidly
  • Multiple skin cancers that are very close together

*The above Mohs surgery information has been provided by the American Academy of Dermatology.

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