What is Mohs surgery?

Mohs surgery is a precise surgical technique used to treat skin cancer. Also known as micrographic surgery, Mohs delivers outstanding cosmetic results, the lowest recurrence rate of any skin cancer treatment method and offer the highest chance of a complete cure.

What happens during Mohs surgery?

During Mohs surgery, thin layers of cancer-containing skin are progressively removed and examined under a microscope until only healthy, cancer-free tissue remains. The goal of this type of surgery is to remove as much of the skin cancer as possible, while doing minimal damage to the surrounding healthy tissue.

Mohs Surgery at The Polyclinic

At The Polyclinic, Mohs surgery is performed by Dr. Daniel Berg, a fellowship trained dermatologic surgeon with more than 20 years of experience in the field. Dr. Berg specializes in Mohs and cosmetic dermatologic surgery and has performed over 15,000 Mohs and reconstructive skin cancer surgeries. The surgery is performed on an outpatient basis using a local anesthetic. The lab work is also done immediately on site. Among the advantages of Mohs surgery is that the patient knows the results right away and usually does not leave the appointment until all of the skin cancer has been removed.

When is Mohs used?

Mohs surgery is used to treat basal cell carcinoma and squamous cell carcinoma, as well as some kinds of melanoma and other more unusual skin cancers. Mohs surgery is useful for skin cancers that:

  • Develop on areas where preserving cosmetic appearance and function are important
  • Have recurred after previous treatment or are likely to recur
  • Are located on scar tissue
  • Are large
  • Have edges or borders that are hard to define
  • Grow rapidly

Often Dr. Berg is able to treat the skin cancer after receiving the proper documentation from the referring provider, thus avoiding the need for an initial consultation with him. But, some lesions do require a pre-operative consultation with Dr. Berg to determine the best course of action for the specific type of skin cancer and also to identify any needed coordination with other providers.

How to Prepare for Mohs Surgery

Once the appointment for surgery is set, the patient will be given a detailed list of instructions to follow beforehand. There may be a need to:

  • Stop the use of certain medications temporarily
  • Stop certain foods and beverages a set number of hours before the procedure
  • Stop smoking
  • Allow a full day for the procedure as it is difficult to predict how long it will take.

During a Mohs Procedure

At The Polyclinic, Mohs surgery is done by Daniel Berg, MD as an outpatient procedure. The office also has an onsite surgical suite and a laboratory for the microscopic examination of tissue. The surgery starts early in the morning and is completed the same day, depending on the extent of the tumor and the amount of reconstruction necessary.

Patients receive local anesthesia and should not experience discomfort. You will not be asleep during this procedure. After the area has been numbed, Dr. Berg removes the visible tumor along with a thin layer of surrounding tissue. The tissue is prepared and put on slides to examine under a microscope. If there is evidence of cancer around the outer edges of the removed tissue, Dr. Berg takes another layer of tissue from where the cancer was detected. These steps are repeated until all samples are free of cancer, minimizing the loss of healthy tissue.

Because this procedure is done in an outpatient setting with local anesthesia, recovery generally involves resting and simple wound care. Some patients may experience mild discomfort, bleeding, redness or inflammation which are typically temporary and easily managed.

Follow-Up Exams

Mohs surgery has a high cure rate for skin cancer. There may however be a small risk of cancer recurrence or developing another skin cancer. Once diagnosed with skin cancer, there is an increased risk of developing another compared with people who have never had skin cancer. Regular follow up visits with a general dermatologist or the family doctor should be scheduled to spot any new skin cancer.