MOHS SURGERY – COMPLETELY REMOVE SKIN CANCER

Mohs Surgery is the most effective surgical procedure to remove Basal Cell Carcinomas (BCC’s) and Squamous Cell Carcinomas (SCC’s), two of the most common types of skin cancer. Another common name for this procedure is Mohs Micrographic Surgery (MMS). 

Mohs surgery provides the highest cure rate for skin cancers and is one of the best ways to remove skin cancer. This type of surgery is done in stages in order to remove all the skin cancer cells without removing any healthy tissue. 

The entire procedure and pathology are conducted in-clinic, in one visit. Mohs surgery eliminates the need for multiple invasive procedures that only prolong patient anxiety and recovery. Other benefits of Mohs surgery include:

• Completed in a single visit
• Lab work completed on-site
• Smallest scar possible
• Examination of 100% of tumor margins
• 99% cure rate for untreated skin cancer
• 94% cure rate for previously treated skin cancer

Mohs surgery was developed by Dr. Frederic E. Mohs in the late 1930s. In the early years, Mohs surgery was known as “Chemosurgery,” a procedure that applied a zinc chloride paste to the skin and covered it with a surgical bandage until the affected cells were completely penetrated. Doctors then removed the penetrated area for testing and treatment. 

The process was tedious, and in some instances, would take days to complete. Only the area that had absorbed the zinc chloride cream could be tested for the presence of skin cancer cells.

In 1953, Dr. Mohs was preparing to remove cancerous cells from a patient’s eyelid but was extremely apprehensive about using the zinc chloride so close to the patient’s eye. Instead, Dr. Mohs opted to use local anesthesia to numb the site and conservatively excise a tissue sample from the cancerous area. 

He then “instantly” viewed the tissue under the microscope to determine whether the edges were clean and free of cancer; if they weren’t, he immediately removed additional tissue and continued to evaluate the edges until he completely removed the patient’s skin cancer. 

This ground-breaking procedure helped speed up testing and procedure and was eventually named Mohs Micrographic Surgery (MMS).

The idea behind Mohs surgery is to keep as much healthy skin untouched by surgery. To ensure that treatment only occurs on affected areas, doctors complete the procedure in steps. 

Step 1: Numbing

Upon arrival, Dr. Brian Matthys or Dr. Nicholas Rudloff will mark the Basal Cell and or Squamous Cell Carcinomas locations. These areas then receive local anesthesia (lidocaine) to numb the surgical area. Local anesthesia reduces the risk of general anesthesia complications, allowing skin cancer removal to be completed in the doctor’s office rather than a surgical center.

Step 2: Initial removal

After the area is numb, the first step is to remove the visible skin cancer/tumor. While some skin cancers may only be on the surface of the skin, some may be deeper. After removing the top layer, your doctor will bandage your skin as you wait for the results.

Step 3: Testing

Doctors then send this sliver of skin to the in-office laboratory to examine it for cancerous cells. Your doctor will look at the tissue’s edges and underside under a microscope to determine if more removal is needed. 

Step 4: Repeat as needed

After the initial tumor removal, your doctor will continue to separate small slivers of tissue from the surrounding area and immediately screen the skin cells in our in-office laboratory to see if cancerous cells are still present. 

If they are, the process is repeated. This continues until the skin is free of all skin cancer, which can take three or more hours, depending on the severity.

Step 5: Repair

Most of the time, the area is closed with stitches. If the affected area is more significant or in a more prominent area like the face, reconstruction may require a skin flap or a skin graft. Then, your doctor will bandage you up and send you home with specific Mohs surgery recovery instructions.

Healing time will vary depending on the location, size, and depth of the skin cancer. Most people are back to work the next day with some minor discomfort. 

For the fastest and most comfortable recovery, it’s essential to follow all of your doctor’s aftercare instructions.

It varies from person to person. Most Mohs surgeries go quickly, but depending on the location and the size of your skin cancer, having skin cancer removed can sometimes take 3+ hours.

Before surgery, Epiphany Dermatology will go over the procedure with you and provide an estimate for how long the operation will take.

In most cases, people can take their daily medications prior to surgery. However, some medications should not be taken.

Patients should consult with their physicians on what medications they are currently taking and if it is safe to continue using them on the day of Mohs surgery.

Fasting is not usually required. But again, confirm with your physician before your procedure.

Epiphany Dermatology & Medical Day Spa is a skin and cancer center leader in Kansas City, providing complete, comprehensive, and compassionate care.

Our Board-Certified Physicians, Surgeon, and Pathologist Brian Matthys, DO and Nicholas Rudloff, DO perform Mohs Surgery at Epiphany Dermatology’s Riverside, MO and St. Joseph, MO. 

If you have any questions regarding Mohs Micrographic Surgery (MMS) or would like to schedule an initial visit with our Kansas City skin and cancer experts, please contact us:

Make an appointment today!
Call: (816) 205-8120
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Locations
1805 NW Platte Rd., Suite 120
Riverside, MO 64150  |  Riverside Directions

805 N 36th St., Suite D
St. Joseph, MO 64506  |  St. Joseph Directions