What is Mohs Surgery?
Mohs surgery is a specialized surgical technique developed by Frederic Mohs, MD, in the 1930’s. The procedure involves removing a skin cancer in layers. After each layer is removed, it is examined under a microscope to determine whether residual cancer remains and, if present, the precise location. Additional thin layers are precisely removed until no evidence of cancer cells remain.
Why choose Mohs Surgery?
- Use of a microscope allows the surgeon to be precise, thereby allowing removal of cancerous cells while sparing normal tissue. This minimizes the potential for scarring. It also minimizes the risk of tumor recurrence resulting in the highest cure rate of all skin cancer treatments – up to 99%.
- It is primarily used to treat basal and squamous cell carcinomas, especially those on the head, neck, hands, feet, and/or genitalia region. Cancers that are large or recurrent in nature are also an indication for Mohs surgery. Melanoma and a variety of more rare skin cancers may also be treated with this technique.
- The procedure is performed under local anesthesia and can be done in a physician’s office.
- The surgery is completed in one day in almost all cases. Most patients require 1-3 stages for complete removal of the tumor. Surgical time for removal of a tissue layer is 5-10 minutes. Wait time for tissue processing and results is 30-60 minutes.
Once all of the skin cancer cells have been removed, you will be left with a surgical wound. Several options will be available to repair the wound. We will discuss the various options and recommend the one with the best functional and cosmetic outcome.
- Granulation – Shallow wounds on certain locations of the body will heal themselves very nicely, thus requiring no further surgery. Reconstruction surgery can be performed at a later time if needed.
- Side to side closure – Excellent results are often possible by simply stitching the wound edges together with sutures. This works best for small defects when the scar can be hidden within a wrinkle.
- Skin Graft – Skin grafting involves covering the wound with skin obtained from another part of the body (donor site). The graft donor site, usually in front of or behind the ear or near the collar bone, is usually sutured side to side or left to heal by granulation.
- Skin Flap – Flaps involve the movement of adjacent healthy skin to cover the surgical wound. Skin flaps provide excellent results given the skin color and texture match.
- Consultation with another reconstructive surgeon – Almost all surgical defects are repaired by the Mohs surgeon immediately after removal of the skin cancer. If your surgery becomes extensive, involves a sensitive functional area, or you request it preoperatively, we will seek the assistance of another physician (usually ENT, Plastic, or Oculoplastic Surgeon) for reconstruction of the surgical defect. Usually, you will see one of these physicians a few days before or on the day of your Mohs surgery. The reconstruction may be scheduled on the same day or within a few days of the Mohs surgery.
Who should perform Mohs Surgery?
We recommend choosing a surgeon who is a member of the American College of Mohs Micrographic Surgery and Cutaneous Oncology (ACMMSCO). ACMMSCO provides specialized training for Mohs surgeons known as a fellowship. Mohs surgery fellowship programs are an intense, 1-2 year period of specialized training in excision, frozen section pathology, and advanced reconstruction. Only members of the ACMMSCO have completed this additional year of training beyond residency to specialize in Mohs surgery.
Mohs Surgery at Southeast Dermatology
If you are scheduled for Mohs surgery with Tarek Fakhouri, MD, at Southeast Dermatology, please arrive at the clinic 10-15 minutes prior to your scheduled appointment.
Mohs/Dermatologic Surgery Unit
Memorial Hermann Southeast, Medical Plaza 1
11914 Astoria Blvd, Suite 570
Houston, TX 77089
- Eat a good breakfast unless advised otherwise.
- Shower the morning of your surgery with antibacterial soap.
- Wear comfortable clothing.
- Do not wear makeup.
- Take your regular medications at the times you routinely take them.
- If you have artificial heart valves, artificial joints, or have been told in the past that you require antibiotics prior to surgery, please notify our office at 281-481-0033. If you already have the antibiotic, please take it on the morning of surgery prior to your appointment.
- Please remember, this is a surgery visit not an office appointment. Since it is difficult to estimate the time your surgery will require (ranges from 2-6 hours), we recommend you bring reading or work materials. Our surgical rooms have radio to help pass the time as well. Space is limited, so we recommend only 1 family member accompany you to the visit.
- Please verify that our office has the correct insurance information to bill the services rendered to you. You may be subject to a deductible or co-payment prior to the time of service. If you do not have insurance, you will be responsible to pay your bill at the time of service.