Mohs Surgery

When a person is diagnosed with skin cancer, Mohs Surgery is a common treatment used to remove the growth and prevent the cancer from spreading. This treatment is most often recommended for the two most common types of skin cancer: both basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs). Prompt treatment is essential to stop the cancer and maintain optimal health in the future. Specific surgical techniques ensure that all cancerous growth is removed, giving the doctor peace of mind to know that they left clean edges and kept as much of the healthy tissue in place as possible.

What is Mohs Surgery?
Types of Mohs Surgery
Why Mohs Surgery?
What are Concerns for Mohs Surgery?
Steps to getting your procedure
Cost of Mohs Surgery
Why Yes Doctor for Mohs Surgery
Frequently Asked Questions
Yes Doctor’s Plastic Surgery Procedure Mohs Surgery

What is Mohs Surgery?

Mohs Surgery, often known in the medical industry as Mohs microscopic surgery, is an effective method for removing skin cancer – especially when the growth is located in a visible area of the body. Since there is a high risk of cosmetic concerns after removing skin cancer, this treatment is often recommended to minimize the scars post-surgery. This technique received its name from the surgeon who discovered the method: Dr. Frederic E. Mohs. He created this technique in the 1930s, and it is still used today with modern upgrades to improve overall results. What makes Mohs Surgery unique? The way the surgery is performed allows the surgeon to remove the cancerous growth with more precision. The goal is to eliminate the cancer cells while preserving the healthy tissue as much as possible. It’s easy to see why Mohs Surgery is popular because the cure rates are relatively high when using this method for removing skin cancers. It is often necessary to use this surgery for skin cancer growths that have poorly defined edges and/or are spreading aggressively. Specialists will also recommend this surgery if the tumors are considered high-risk, in a sensitive area of the body, or other high-risk factors are in play.

A systematic, precise method is used to remove the cancerous cells during this surgery. The surgeon works layer by layer without needing to cut out an area much bigger than the cancer location. To begin, the treatment area is numbed using a shot that delivers local anesthesia. Then, the visible tumor and a small layer of tissue surrounding the tumor are removed. The extra tissue is tested in a laboratory setting on site, with the surgeon looking at the cells through a microscope.The purpose of on-site testing is to determine whether cancer cells are located in the surgical margins around where the tumor was removed. If cancer cells are detected in the on-site lab, the surgeon will go back to work to remove another layer of tissue and repeat this process. This process is repeated as often as necessary to ensure no cancer cells remain. As a result, the patient has the best possible cure rate, with a minimal risk of healthy tissue being removed during the surgery. Since the method is deliberate and done step-by-step, the removal process only targets the skin that is affected by cancer – helping to keep the healthy tissue in place.

Types of Mohs Surgery

  • Which Mohs Surgery is Right for You?

    There are actually several different types of Mohs Surgery procedures that can be used, so your doctor will provide specific information and recommendations to determine the ideal treatment for your needs. Various factors will be evaluated when determining your ideal treatment plan. For example, the doctor will look at the location of the cancer, the type of skin cancer, the extent of the growth, and overall size. Additionally, it’s important to consider the patient’s cosmetic goals and overall health to know the best treatment for any type of surgery. The importance of tissue preservation varies due to the location of the skin cancer. When the cancer is in a very visible location, such as the face or the hands, then it is often a higher priority to preserve the tissue in order to minimize the cosmetic impact after the surgery. On the other hand, cosmetic concerns aren’t as big of an issue when the surgery is being done on a part of the body that isn’t often seen. If you have skin cancer, a consultation with an experienced dermatologist is the first step. Make sure you are working with a specialist who is trained in various types of surgical techniques, including Mohs Surgery. Your individual situation will be assessed, then the doctor can help you decide whether Mohs Surgery or a different type of cancer removal treatment is the best option.

  • Standard Mohs Surgery

    The standard method for Mohs Surgery is the common approach that has been used since the 1930s. This surgery requires a methodical and meticulous approach to remove the tissue layer by layer while completing ongoing tissue evaluation in an on-site lab to determine whether all of the cancer cells have been removed. During this process, the surgeon removes the visible tumor first. Then the layering and testing are next to create clean edges and preserve the healthy tissue as much as possible. The layering continues until it is determined that there are no cancer cells in the tested tissue.

  • Slow Mohs Surgery

    Another method for Mohs Surgery is known as “Slow Mohs” or “Modified Mohs.” This process is similar to the standard surgery. The difference is in the way tissue is tested. With Slow Mohs Surgery, paraffin sections (instead of frozen sections for the standard surgery) are used for testing. The layers of skin are processed rapidly in the laboratory. This process can take 24 hours or more in the lab. This method is sometimes preferred because specific tumor pathologies are better visualized in the paraffin sections instead of frozen sections – improving the accuracy overall.

  • Frozen Section Mohs Surgery

    It’s common for the removed tissue to be frozen; these layers are sectioned off for testing. The tissue can freeze quickly, then the frozen cross sections are examined immediately through a microscope. As with other types of Mohs Surgery procedures, the benefit is that the surgeon can use real-time evaluation to make decisions about how much tissue and skin needs to be removed. It’s easier to remove affected areas precisely while leaving the healthy tissue in place as much as possible. This process allows for both efficient and accurate testing to improve the overall outcomes for both healthy tissue preservation and cancer cell removal at the same time.

  • Mapping Mohs Surgery

    In some situations, mapping the removed tissue sections can be helpful. This process is meticulous in the way the tissue samples are mapped and labeled. As the surgeon removes a layer, they are precise in marking where the tissue came from in relation to the tumor and surgical site. Mapping may be necessary for patients who have particularly complex cases. For example, mapping might be recommended if the tumor is in an area with cosmetic sensitivity. Or, if the tumor has irregular borders, it’s important to know exactly where the cancer cells have spread – and mapping improves the accuracy of this process.

Why Mohs Surgery?

Since Mohs Surgery is effective and specialized, it is used by many dermatologists to remove various types of skin cancer. This treatment is recommended for multiple reasons:

1. High Success Rates: Real-time testing allows the doctor to ensure that all of the cancer cells are removed. Because of this meticulous process, there is a better likelihood of eliminating the tumor completely and reducing the risk of recurrence in the future. The success rates are high when Mohs Surgery is done correctly.

2. Preserving Healthy Tissue: In the past, doctors removed tumors with wide margins to avoid leaving any cancer cells behind. While this process can be effective, it often results in more scarring and cosmetic concerns than necessary. Mohs Surgery reduces the amount of healthy tissue that needs to be removed, which is especially beneficial in visible areas such as the face.

3. Real-Time Margin Assessment: Even if the surgeon removes the visible tumor, healthy cancer cells may be left behind due to irregular borders. Real-time assessment increases the likelihood of removing all of the tumor cells simultaneously, reducing the need for additional treatments or surgeries in the future.

4. Minimizing Scarring: Any time tissue is removed from the skin, it will leave a scar. By preserving healthy tissue through Mohs Surgery, it helps to reduce the appearance of the scar (compared to other skin cancer removal techniques).

  • High Cure Rates
  • Tissue Preservation
  • Precise Margin Assessment
  • Complex or Large Tumors
  • Minimize Scarring

What are Concerns for Mohs Surgery?

Potential complications can occur with Mohs Surgery and other types of skin cancer removal methods. This treatment is considered safe and effective, but it’s important for patients to learn more about the possible side effects and risks of this surgery. Some complications can occur whenever a surgical procedure is completed, regardless of the location or treatment method. These might include scarring, infection, bleeding, slow wound healing, and/or nerve damage. Some patients are also at risk of allergic reactions to the anesthesia and/or medications used for the treatment. Another potential concern is the cosmetic outcome after treatment. Even though the goal is to preserve natural tissue and minimize the appearance of scarring, there is still a possibility that the remaining scars can affect the patient’s appearance. This concern is heightened when skin cancer is located in a very visible place, such as on the face or neck. Even though the surgeon is proactive in minimizing the scarring, there is always a risk of scarring. Talking to your doctor about potential outcomes and expectations before the treatment is important. When the tumor is big, and a large portion of the skin must be removed to ensure clear margins, then it’s possible that reconstruction might be necessary after Mohs Surgery. The goal is to restore the appearance of the treatment area.

  • Skin Cancer Treatment

    The most common reason Mohs Surgery is used is when a patient has been diagnosed with basal cell carcinoma (BCC) or squamous cell carcinoma (SCC). If the tumor is aggressive, large, or has irregular borders, then Mohs Surgery is one of the best methods that can be used to eliminate the cancer while also avoiding the risk of spreading in the future. Additionally, this treatment is best when the skin cancer is located in a visible or sensitive area.

  • Skin Cancer Cure Rates

    Mohs Surgery is a good solution for skin cancer patients because the way this treatment is done improves the short-term and long-term outcomes. Since Mohs Surgery uses such precision and real-time testing, there is a higher chance that all of the tumor cells can be removed – which reduces the risk of skin cancer recurrence in that location in the future. As a result, there is a higher chance of successful treatment.

  • Recurring Skin Cancers

    Some patients have skin cancer removed with other methods, then cancer comes back in the same location. If a patient has recurring skin cancer in an area that was previously treated, then it’s more important than ever to ensure that the tumor is properly removed this time. Other methods may not remove cancer completely because the surgeon was unaware of other cancer cells left behind. Mohs Surgery is the ideal treatment to ensure clean margins without causing unnecessary damage to the healthy surrounding tissues. If you have recurring skin cancer, then the best option is to find a surgeon who has experience with Mohs Surgery.

Steps to getting your procedure

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Step 1

Research

Step 2

Matching with a doctor

Step 3

Getting financing

Step 4

Booking a consultation

Cost of Mohs Surgery

The overall cost for Mohs Surgery depends on the size of the cancer, where it is located, and the complexity of your medical case. For example, the surgeon will need to evaluate the location of the tumor and how much needs to be removed to estimate the actual cost of the treatment. Other factors that can affect the cost of this surgery include where the treatment is completed and the surgeon’s expertise. Doctors who are more experienced and in higher demand tend to have higher prices compared to other providers. Because there are multiple steps for the layer removal and testing, this method of skin cancer removal tends to be more expensive compared to other types of treatments. Real-time tissue evaluation requires additional staff members and specialized equipment to ensure accuracy and precision. For example, there is usually a pathologist on site who is working with the surgeon to test the tissues throughout the treatment time. All of these factors contribute to the amount you will pay for the treatment. Finally, other related costs might also need to be paid, such as pre-operative and post-operative appointments with the surgeon, anesthesia fees, and reconstruction surgery costs if necessary. According to RealSelf, the average cost of Mohs Surgery is $881. But this price can be as high as $3,615 for more complicated cases. The good news is that many insurance providers pay for the cost of Mohs Surgery. You might have full coverage, only requiring your co-pay and/or deduction for your out-of-pocket expenses. Or some insurance providers only provide partial coverage. When the treatment is determined medically necessary, then it is likely that insurance coverage will be available.

Why Yes Doctor for Mohs Surgery

There are two reasons why Yes Doctor is a preferred resource for patients who need Mohs Surgery. First, our directory provides detailed information about skilled surgeons offering this treatment. You can find a provider close to home. Additionally, Yes Doctor offers financing solutions for patients who are unable to pay for the cost of surgery out-of-pocket. These medical financing plans are designed with competitive interest rates and affordable monthly payments to fit the unique financial situation of every patient. Not only can financing be used for medically necessary surgery, such as Mohs Surgery, but it can also be used for cosmetic treatments as desired by each patient.

Frequently Asked Questions

The length of the surgery will depend on the size of the affected area and where the skin cancer is located. When cases are more complex, then the surgeon will require additional time to complete the treatment successfully. Most of the time, the procedure is done in a few hours. If additional layers need to be tested, it can require extra time. The surgeon will continue working until they are confident that all of the cancer has been removed and the tissue testing shows clean margins.
You shouldn’t feel any pain during the appointment because local anesthesia is used to numb the treatment area. Most patients have little or no discomfort during the surgery. You might feel slight pressure or a sensation when the surgeon removes the layers of skin. After the numbing wears off, it is common to have soreness or pain in the treatment area. Most surgeons recommend the use of over-the-counter pain medications or prescriptions to manage this pain. Post-operative pain will decrease within a few days. Many patients take pain medications for less than a week until the symptoms are minimal enough that pain relievers are no longer necessary.
You might need stitches after Mohs Surgery, depending on the location and size of the surgical area. If it is a small skin cancer and not a lot of tissue needs to be removed, it will likely heal on its own without using stitches to close up the wound. On the other hand, some larger areas of skin cancer removal need stitches or other methods for closing the skin after the treatment is over. The surgeon will evaluate the size of the wound and then choose the ideal method for closing the skin. Proper closure helps to reduce the appearance of scarring in the future.
The recovery experience and time will vary from patient to patient, depending on the extent of the surgery. Most people feel discomfort, swelling, and even bruising after the treatment is finished. These symptoms start to decrease in the coming days. You can expect to resume your normal activities within a few days after Mohs Surgery. But it will take several weeks for complete healing to occur. Make sure to stay consistent with follow-up appointments as recommended by your surgeon. Also, adhering to post-operative instructions is important to promote healing and keep the wound clean to prevent infection.