The Center for Skin Surgery offers the following services:
Advanced Dermatologic Surgery
Cosmetic and Laser Procedures
Mohs Micrographic Surgery, an advanced treatment procedure for skin cancer, offers the highest potential for recovery—even if the skin cancer has been previously treated. This procedure is state-of-the-art treatment in which the physician serves as surgeon, pathologist and reconstructive surgeon. It relies on the accuracy of a microscope to trace and ensure removal of skin cancer down to its roots. This procedure allows dermatologists, trained in Mohs Surgery, to see beyond the visible disease, and to precisely identify and remove the entire tumor, leaving healthy tissue unharmed. This procedure is most often used in treating two of the most common forms of skin cancer: basal cell carcinoma and squamous cell carcinoma.
The cure rate for Mohs Micrographic Surgery is the highest of all treatments for skin cancer—up to 99 percent even if other forms of treatment have failed. This procedure, the most exact and precise method of tumor removal, minimizes the chance of regrowth and lessens the potential for scarring or disfigurement.
As the process evolved, surgeons refined the technique and now excise the tumor, remove layers of tissue and examine the fresh tissue immediately. The chemosurgical technique developed by Dr. Mohs is no longer used. This reduces the normal treatment time to one visit and allows for immediate reconstruction of the wound. The heart of the procedure—the color-coded mapping of excised specimens and their thorough microscopic examination—remains the definitive part of the Mohs Micrographic Surgical procedure.
Some tumors do not respond to common treatments, including those greater than two centimeters in diameter, those in difficult locations and tumors complicated by previous treatment. Removing a recurring skin cancer is more complicated because scar tissue makes it difficult to differentiate between cancerous and healthy tissue.
Once the obvious tumor is removed, the Mohs surgeon:
If any of the sections contain cancer cells, the Mohs surgeon:
If microscopic analysis still shows evidence of disease, the process continues layer-by-layer until the cancer is completely gone.
This selective removal of only diseased tissue allows preservation of much of the surrounding normal tissue. Because this systematic microscopic search reveals the roots of the skin cancer, Mohs Surgery offers the highest chance for complete removal of the cancer while sparing the normal tissue. Cure rates exceed 99 percent for new cancers, and 95 percent for recurrent cancers.
Besides its high cure rate, Mohs Micrographic Surgery also has shown to be cost effective. In a study of costs of various types of skin cancer removal, the Mohs process was found to be comparable when compared to the cost of other procedures, such as electrodesiccation and curettage, cryosurgery, excision or radiation therapy. Mohs Micrographic Surgery preserves the maximum amount of normal skin and results smaller scars. Repairs are more often simple and involve fewer complicated reconstructive procedures.
With its high cure rate, Mohs Surgery minimizes the risk of recurrence and eliminates the costs of larger, more serious surgery for recurrent cancers. Because the Mohs procedure is performed in the surgeon’s office and pathological examinations are immediately, the entire process can often be completed in a single day.
The Mohs Surgeon
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Only physicians who have also completed a residency in dermatology are qualified for Mohs Micrographic Surgical training.
The American College of Mohs Micrographic Surgery and Cutaneous Oncology currently recognizes more than 60 training centers where qualified applicants receive comprehensive training in Mohs Micrographic Surgery. The minimum training period is one year during which the dermatologist acquires extensive experience in all aspects of Mohs Surgery, pathology and training in reconstructive Surgery.