Mohs surgery/staged excision consists of taking small layers of skin and checking with a microscope if the whole tumor is removed. It allows best preservation of the surrounding skin and ensures that all the tumor is removed. May take longer time since all the processing of the specimens is made immediately after removing the tumor. Mohs /Staged Excisions are performed on the face, neck and hands, in sensitive areas where skin preservation is very important. Simple excision consists of excising a skin cancer with margins. Specimens are checked by pathology and a follow-up visit is scheduled in 2 weeks at which time results are available to confirm that all the skin cancer was removed.
Frequently asked questions about Mohs surgery by patients
Is Mohs surgery/staged excision the best treatment option for all skin cancers?
It gives the best cure rate (up to 99%), for certain lesions where this approach is recommended, but some insurances may not cover Mohs for all skin cancers. If you have any type of suspicious skin lesion you should seek evaluation by our dermatologists. If skin cancer is suspected, the doctor may recommend and perform a biopsy. Mohs surgery may be recommended based on the type and location of the skin cancer, as well as other factors.
Will Mohs staged excision surgery be covered by my insurance plan?
Mohs surgery, if recommended by the dermatologist, is covered by most insurance plans, including Medicare. Please ask your employee benefits administrator and/or our billing specialist to determine if there are any estimated out-of-pocket expenses.
Will skin surgery and Mohs surgery leave a scar?
All surgical procedures have the potential for certain degree of visible scarring. The appearance of a post-Mohs surgical scar will depend on several factors, including size and location of the final defect, individual skin characteristics, and the reconstruction options available. You should keep in mind, however, that the tissue-sparing nature of the Mohs technique may result in a smaller, less noticeable scar than other skin cancer removal methods. The Mohs surgeon also may be able to incorporate suture lines into the patient's natural skin lines and folds. Most scars improve in appearance naturally over time, and future scar revision techniques may be employed if necessary.
My skin cancer is in a very noticeable facial area and I am concerned about my appearance following Mohs surgery. Should I have the skin cancer removal performed by a plastic surgeon?
If it is your preference to have a plastic surgeon perfom the reconstruction after the removal of the skin cancer, you may discuss this ahead of time with our dermatologist/Mohs surgeon during your preoperative visit. Our office will be able to help coordinate this type of shared treatment approach. If the skin cancer involvement is extensive or in difficult areas, our Mohs surgeon will recommend and collaborate with other subspecialties.
What are advantages of the Mohs/staged excision Surgery (provided that this is recommended by the Dermatologist)?
Some skin cancers can be deceptively large – far more extensive under the skin than they appear to be from the surface. These cancers may have “roots” in the skin, or along blood vessels, nerves, or cartilage. Skin cancers that have recurred following previous treatment may send out extensions deep under the scar tissue that has formed at the site. Mohs surgery is specifically designed to remove these cancers by tracking and removing these cancerous “roots.” For this reason, prior to Mohs surgery it is impossible to predict precisely how much skin will have to be removed. The final surgical defect could be only slightly larger than the initial skin cancer, but occasionally the removal of the deep “roots” of a skin cancer results in a sizeable defect. The patient should bear in mind, however, that Mohs surgery removes only the cancerous tissue, while the normal tissue is spared. Therefore, Mohs surgery results in a reduced scar formation, potentially less than than simple excision, give the more conservative tissue removal employed.
Mohs surgery is used in the treatment of skin cancers. Dr. Stein has extensive experience in performing Mohs Surgery.