Mohs surgery is a procedure for removing some forms of skin cancer and other lesions. These surgeries are most often performed on areas like the face, where they can have the effect of minimizing scarring. This doesn’t mean scarring won’t occur but it might be less noticeable than other skin cancer removal methods. Mohs is not an acronym, but refers to the creator of this technique, Dr. Frederick Mohs, and this surgery can have a high success rate due to the way it is performed, with a much lower chance of recurrence of cancers.
The difference between Mohs surgery, also termed chemosurgery, and other forms of removal is that layers of the lesion or cancerous tissue are removed bit by bit. As this is performed, usually in incremental stages, the doctor checks borders of the enlarging wound to be certain it is clear of more cancer by viewing skin samples to detect evidence of cancer remaining. Since this can take several episodes of removal and checking, Mohs surgery can be noted for its length. It might take the better part of a day to remove something like a basal cell skin cancer from the face, due to the removal and check process.
For the person having Mohs surgery, this tends to mean people will be conscious during the procedure but will have a local anesthetic so they don’t feel lesion removal. Some doctor’s offices even tell people to pack a lunch and something to read so they won’t get bored during the check process. Depending on size of lesion, people could experience many episodes of tissue removal and then episodes waiting to be sure that all parts of the lesion are gone. This checking is valuable in minimizing recurrence and the incremental approach means doctors don’t remove very much healthy tissue, resulting in less scarring.
Once all evidence of a lesion is removed and the area affected has been reduced to healthy tissue, doctors may decide to close the wound in several different ways. This decision may depend on doctor preference, location of the surgical wound and other factors. Typically, wounds receive some careful stitching and are then covered with a wet to dry packing. The moisture also helps to minimize scarring. Depending on the type of Mohs surgery, doctors usually make plans to see the patient a few weeks later to check on the wound for any signs of infection and ultimately to remove stitches.
There are several different types of doctors who can perform Mohs surgery. Principally, dermatologists and plastic surgeons may offer this. Not just any doctor can use this technique and in most places a doctor cannot claim to be a Mohs surgeon without several years of formal training in the procedure, beyond other medical training. There are many people that take this training because so many patients get facial lesions and would prefer little scarring when they’re removed and minimal chance of them coming back. Both large dermatology and plastic surgery practices usually boast at least one Mohs specialist.