Mohs Micrographic Surgery

Mohs Micro­graph­ic Surgery is a spe­cial­ized micro­scop­i­cal­ly con­trolled tech­nique uti­lized to treat the most com­mon forms of skin can­cers, such as basal cell car­ci­no­ma and squa­mous cell car­ci­no­ma. It is pri­mar­i­ly used to treat can­cers on areas like the scalp, face, neck, hands, feet, and gen­i­tals, where pre­serv­ing healthy tis­sue is cru­cial. This tech­nique is also suit­able for skin can­cers in areas pre­vi­ous­ly treat­ed with radi­a­tion, those that have recurred after ini­tial treat­ment, aggres­sive or rapid­ly grow­ing can­cers, and can­cers in patients with weak­ened immune sys­tems. Your physi­cian will eval­u­ate whether Mohs micro­graph­ic surgery is the best option for your skin can­cer based on its type, loca­tion, and size.

Quin­cy Med­ical Group Der­ma­tol­o­gist Dr. Sumul Gand­hi is fel­low­ship-trained in Mohs surgery and has spe­cial­ized skills in der­ma­tol­ogy, der­matopathol­o­gy and exci­sion­al and recon­struc­tive surgery. Mohs surgery dif­fers from stan­dard sur­gi­cal treat­ment in that 100% of the mar­gins of excised tis­sue are exam­ined in Mohs surgery, while stan­dard exci­sion exam­ines <1% of the mar­gin. This enables Mohs surgery to offer a high­er cure rate when com­pared to stan­dard exci­sion with mar­gins and also allows preser­va­tion of healthy, unaf­fect­ed skin.

Before The Procedure

The doc­tor will explain what you should do to pre­pare for your surgery. You may be asked to stop smok­ing and tak­ing cer­tain med­ica­tions, such as aspirin or oth­er blood thin­ners. How­ev­er, you should not stop tak­ing any pre­scribed med­ica­tions unless instruct­ed to do so by the doc­tor. You may be asked to arrange for some­one to take you home after your surgery.

Dur­ing The Procedure

Mohs surgery takes place in a reg­u­lar out­pa­tient office set­ting and takes sev­er­al hours. You do not need to be asleep (gen­er­al anes­the­sia) as you would with oth­er surg­eries. The areas on your skin where the tumor is locat­ed will be numbed. Dur­ing the pro­ce­dure, the Mohs sur­geon removes the can­cer­ous tis­sue one lay­er of skin at a time and exams the it under a micro­scope to look for can­cer. If can­cer is still present, anoth­er lay­er of tis­sue will be tak­en and exam­ined. This is repeat­ed until there is no can­cer remain­ing. Any bleed­ing dur­ing the pro­ce­dure will be stopped by apply­ing a pres­sure dress­ing, using a small probe to heat the skin (elec­tro­cautery), or through stitches.

After The Procedure

Tak­ing prop­er care of your wound after surgery will help your skin look its best. Your doc­tor will talk with you about your options for heal­ing. Small­er wounds may be allowed to heal on their own, but larg­er wounds may require stitch­es or skin grafts tak­en from anoth­er part of your body. With this surgery, the small­est amount of tis­sue pos­si­ble is removed, so you will have a small­er scar than you might have with oth­er treat­ment options. Mohs surgery is gen­er­al­ly con­sid­ered safe, but as with any surgery, there are pos­si­ble risks. While rare, pos­si­ble risks include infec­tion, nerve dam­age, and keloid scarring.

If you have any ques­tions, please call the Quin­cy Med­ical Group Der­ma­tol­ogy Depart­ment at (217) 222‑6550, ext. 3435.