The Cosmetic Skin and Surgery Center now offers the state-of-the-art Mohs Micrographic Surgery, a procedure designed for the effective removal of skin cancer, headed by Dr. Matthew B. Quan, our resident Mohs surgeon. This procedure was designed in 1930s to remove certain skin cancers that are unresponsive to more traditional treatments and therapies by Fredrick Mohs, M.D. of The University of Wisconsin. A special fellowship is a requirement of the American College of Mohs Micrographic Surgery and Cutaneous Oncology to become a Mohs surgeon. A certified histotechnologist is also employed to work alongside the Mohs surgeon. Tissue specimens are processed by the histotechnologist, while the Mohs surgeon functions as both pathologist and surgeon.
Your skin cancer may require special treatment, which is why may you have been referred to our surgical suite for Mohs surgery.
To effectively treat skin cancer, there are several methods available. Size, tumor type, location, and previous treatments are some of the factors that determine the choice of treatment. Mohs surgery is known to have the highest cure rate for both primary and recurrent cancers, and is often used on basal and squamous cell skin cancers. The very complex Mohs surgery procedure involves a combination of surgical excision and on-the-spot microscopic examination of the tissue specimen with processing techniques using frozen tissue. The five steps involved in the process are as follows:
- A local anesthetic, Lidocaine, is used to numb the skin.
- A thin, bowl-shaped layer of skin which contains the tumor is surgically removed.
- In the laboratory, the specimen is sliced and divided, and subsequently mapped, numbered, color-coded, sectioned, and stained.
- The Mohs Surgeon then determines if the entire tumor has been removed by examining each section microscopically.
- The skin defect is then repaired once complete removal of the tumor is confirmed. However, steps 1, 2, 3, and 4 are repeated if traces of the tumor still remain.
With Mohs surgery, the entire surgical margin is examined, and we will be able to identify and locate any leftover cancer, if the tumor is still present. This means that if we need to remove another layer of skin, we are able to do so in the precise area of the remaining cancer. This ensures that normal, healthy skin remain untouched. Mohs Surgery may need to be performed in multiple stages because some skin cancers are very complicated. It takes approximately 60 minutes to examine each stage. The entire day must be reserved for this surgery as the Mohs procedure may take a while, especially with multiple stages involved.
Please expect some scarring. Unfortunately, some skin cancers may be larger than what you can see, so the scars may be significantly larger, as well. Removing all the cancer on the same day that you come in is our primary goal. After the cancer is removed, we will do our best to leave you as cosmetically intact as possible.
For one to two weeks after the surgery, keeping your head elevated with an extra pillow while resting or sleeping is advised, if the cancer is on the face. By doing so, swelling is reduced significantly. After your procedure, you may end up with one or two black eyes if the cancer is close to your eyes with the worst being three days after the fact. Although no additional treatment is necessary, it helps to apply cold compresses. Weeks or even months of fastidious wound care is required after the stitches are removed, even if the site looks well. We reiterate not planning any trips or important social events for several weeks following your surgery.
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The Doctors at Cosmetic Skin & Surgery Center are all board-certified so you know that they have been certified and have extensive training. Our complete and total skincare center is highly recognized and awarded by major organizations , which means we meet very high standards for safety, quality of care, and infection prevention.