Dawes Fretzin Dermatology Group is proud to offer Mohs Micrographic Surgery as a dermatologic treatment.

In an effort to help our patients understand Mohs Micrographic Surgery, we’ve answered some of the frequently asked questions by patients undergoing Mohs surgery. If you have been scheduled for Mohs surgery, we encourage you to take time and read this material.

Hopefully it will answer your questions and make your surgery day easier.

Mohs micrographic surgery is a specialized, highly effective technique for the removal of skin cancer. The physician serves as surgeon, pathologist, and reconstructive surgeon. It relies on the precision and accuracy of a microscope to trace and ensure complete removal of skin cancer. The procedure was developed in the 1930’s by Dr. Frederic Mohs. The procedure has been modified and refined over the years. Mohs surgery differs from other skin cancer treatments in that it permits the immediate and complete microscopic examination of the removed cancerous tissue, so that all “roots” and extensions of the cancer can be eliminated.

There are two primary advantages. First, by using microscopic examination of the tissue as a guide, the Mohs surgeon is better able to remove all of the skin cancer. Secondly, by carefully mapping out the tumor, the surgeon removes cancerous tissue and leaves as much normal skin as possible.

There are three main ways your surgical wound may be handled:

Direct close of the wound – In most instances, surgical wounds are sutured (sewn) closed.

Skin graft – In some instances, it is necessary to remove skin from in front of the ear or some other site and graft it over the wound.

Second intention healing – The body has an excellent capacity to heal open wounds. This healing period is approximately three to six weeks depending on the size of the wound. It requires regular wound care.

In addition to wound size and location, the surgeon considers other factors to determine how your wound will be handled. This will be fully discussed with you on the day of surgery. Sometimes, for more extensive repairs, we will ask that you return the following day for the repair of your surgery site.

All surgical procedures have the potential for some degree of visible scarring. The appearance of post-Mohs surgical scarring will depend on several factors, including size and location of the final defect, individual skin characteristics, and the reconstruction options available.

No. The surgery is well tolerated with local anesthesia. Because the surgery may be time-consuming, the risk of prolonged general anesthesia is thus avoided.

Most Mohs cases can be completed in three or fewer stages, lasting half a day or longer. However, it is not possible to predict how extensive a cancer will be, as the extent of a skin cancer’s “roots” cannot be estimated in advance. Most of the time is spent waiting for tissue to be processed. It is advisable to reserve the entire day for the procedure. Also, bring reading materials, needlework, etc. and a snack or lunch with you on the day of surgery.