Mohs Micrographic Surgery for Skin Cancer
The best cure rate.
Removes ALL the cancer — including the "roots."
Leaves healthy skin, a smaller scar.
Mohs Micrographic Surgery is the most effective treatment for skin cancer, because it eliminates all of the tumor — including any hard-to-detect extensions. Dr. Ramsdell removes the visible cancerous tissue, then excises and examines microscopic samples of the tissue around it. We keep taking and testing tissue samples in a multi-stage process until the samples — and you — are cancer free.
This real-time, microscopic examination of tissue is what sets Mohs surgery apart. It eradicates all cancerous tissue — and only cancerous tissue — leaving your healthy skin intact.
Conditions
RECURRING SKIN CANCER When a treatment doesn't eliminate all cancer cells the cancer will sometimes extend "roots" deep under the scar tissue along blood vessels, nerves, or cartilage. Mohs surgery was designed specifically for these cancers as well as cancers that are at a high risk for recurrence.
CANCERS AROUND THE FACE, HANDS, FEET, AND GENITALS Mohs surgery is also appropriate when preservation of healthy tissue is important for cosmetic or functional purposes. Cancers in the areas of the nose, eyelids, lips, hairline, hands, feet, and genitals are typically treated with Mohs surgery.
The Treatment
PREPARING FOR MOHS SURGERY
Eat and sleep well. Get a good night's rest and eat normally before your surgery.
Take your meds. Take any prescription medication as usual, unless your doctor tells you otherwise. Avoid aspirin and aspirin substitutes (Advil, Motrin, Nalfon, Naprosyn, etc.) for 72 hours before surgery. You may take Tylenol any time prior to surgery.
Dress for comfort. Wear comfortable, casual layers for your surgery.
Bring food and entertainment. Prepare for the lulls in treatment while we are testing your tissue in the lab.Bring a snack and reading material or your favorite tunes.
Arrange for a ride home. You will need someone to get you home and settled safely after your surgery.
DURING MOHS SURGERY
What to expect For your comfort, schedule, and peace of mind, Dr. Ramsdell performs outpatient Mohs surgery in his own surgical suite, using his own in-house lab and staff. You will need only a local anesthetic and will be awake during the procedure.
We cannot predict how involved your surgery will be, so we cannot give you an accurate estimate of its duration.
Although most Mohs surgeries can be completed in three or fewer stages, requiring less than four hours, we recommend that you reserve the entire day for your procedure.
The diagrams at right illustrate the Mohs procedure.
Post-surgical reconstruction When your surgery is complete Dr. Ramsdell will explain your options.
NATURAL HEALING: If the surgical site is small your best option may be to let the body heal naturally, with no additional surgery. This may also produce the best cosmetic result.
WOUND REPAIR BY DR. RAMSDELL: For smaller surgical sites Dr. Ramsdell may suture the sides of the wound together. For areas with little tissue available for suturing Dr. Ramsdell may close the wound using a flap of surrounding skin or a graft of skin from another part of the body.
AFTER MOHS SURGERY
Bruising, swelling You may experience some bruising and swelling around the surgical site, especially if your surgery was near the eye area.
Discomfort Most patients do not complain of significant pain. Usually Tylenol is all you will need for relief. However, Dr. Ramsdell will prescribe stronger pain medication if you need it.
Scarring Mohs surgery leaves one of the smallest surgical scars possible. After six to 12 months it is often barely noticeable. If you want to diminish to appearance of your scar, however, you have options.
INDENTED SCAR: A dermal filler such as Restylane or Juv̩derm can elevate a depressed area.
ROUGH OR RAISED SCAR: Laser resurfacing or chemical peeling can smooth an elevated area.
RED OR BROWN DISCOLORED SCAR: A scar will diminish much faster with FotoFacial™
Intense Pulsed Light (IPL®
) treatment than it would on its own.
Precautions
The surgical area may be tender for several weeks or months after surgery, especially if large amounts of tissue were removed. Rarely, some patients experience intermittent itching or shooting pain in the surgical area.
Tiny nerve endings are cut during Mohs surgery, which may result in temporary or permanent numbness. If a large tumor is removed or if extensive surgery is required, a nerve to a muscle may be cut, resulting in temporary or permanent weakness. This is an unusual complication.
Occasionally some of the skin in a graft or flap may not survive, requiring additional repair.
Insurance
Most insurance policies cover the costs of Mohs surgery and the reconstruction of the resultant surgical area. Please contact your insurance carrier directly for the most current payment information. Our insurance billing specialists are
also available to help.
For More Information
www.mohssurgery.org
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William M. Ramsdell, MD Dermatologist, Medical Director 
