MOHS MICROGRAPHIC PROCEDURE
Mohs surgery aims to remove not only obvious cancerous skin growths, but the cancer’s elusive roots that tend to hide beneath the surrounding normal-looking skin. The technique is very precise, minimizing the chance of cancer regrowth and the potential for scarring.
Basal Cell Carcinoma is the most common type of skin cancer. It is slow-growing, does not metastasize (spread elsewhere), and is rarely fatal. However, if this cancer is left alone, over the years it can eat away at the nose, lips, ears, or even eyes.
Squamous Cell Carcinoma is the second most common type of skin cancer, and it is responsible for 8,000 – 10,000 deaths annually in the United States alone. This type of cancer also grows slowly, but more quickly than basal cell. The lips and ears are particularly vulnerable areas for squamous cell carcinoma.
Malignant Melanoma is the least common type of skin cancer, as well as the most deadly; it is responsible for 75% of the deaths caused by skin cancer. Melanoma is fast spreading, so treatments yield the best results when the cancer is caught early on in its process.
Undergoing skin cancer surgery can seem more than a little frightening, which is why we do all that we can to make the experience as comfortable as possible.
You will be under the hands of an experienced dermatological surgeon who will discuss with you all of your questions and concerns before the procedure begins and help you make a plan for your continued skin care afterwards.
- First, a local anesthetic is used to thoroughly numb the area of the cancer growth.
- Once the area is entirely numbed, the soft part of the cancer is scraped away. The main part of the cancer is often softer than the surrounding skin.
- A thin layer of tissue (about 2-3 mm thick) is then surgically removed from around and under the area.
- Green, black, yellow, and red dyes are added to distinguish top from bottom and left from right for when the doctor later looks at them under a microscope.
- The area is bandaged.
- Initial results are usually back within 30-45 minutes.
The removed cancerous tissue is frozen, sliced into thin layers, placed on glass slides, and stained. These are then scrutinized under a microscope for remaining cancer, any of which are then marked on a diagram.
- You will return to the surgery room, where the remaining cancerous tissues will be removed.
- You are again bandaged and wait while the next set of slides are prepared and examined, as before.
- You again return to the surgery room, where any remaining cancerous tissues will be removed, and the process repeats itself until, with as much certainty as possible, all signs of cancer are removed.
Mohs surgery is one of the most advanced techniques of its kind, offering you the highest possibility for complete removal of cancerous growth.
Afterwards, however, there will be some recovery needed due to the wound left behind from the extraction area.
There are a few different ways that this wound can be cared for and repaired, depending upon the extent of extraction:
- The wound can be stitched up in a straight line.
- A skin graft may be necessary, which is where skin is borrowed from elsewhere on your body and is sewed in a patch over the wound.
- The skin surrounding the wound can be rearranged, while maintaining its blood supply, into a skin flap to cover the wound.
Two weeks before surgery, you should avoid:
- Aspirin or any aspirin-containing drug
- Vitamin E
- Gingko Biloba
- Feverfew, garlic, or ginger capsule
- Ibuprofen, Motrin, or Advil
- Other arthritis drugs
Please be sure to inform the doctor about all of the medications you are currently taking.
The number of treatment sessions required for optimum results entirely depends on the condition being treated and your desired outcome.
Highly effective treatments require 3-6 sessions on average at about 3-5 week intervals, however, treatment of brown spots may only take 2-3 sessions.
While some results are immediate, others can take 3-6 months to appear due to collagen and elastin regeneration.
For long-lasting results, sun protection is key for at least three months after treatment. Avoid direct sun exposure, apply broad-spectrum 30+ SPF sunscreen, and wear protective clothing when outdoors.
During your consultation you may also be given a suggested maintenance and skin care routine to help prolong your results. With careful sun protection and a proper skin care regimen, the benefits of Fraxel® re:store can last years.
If you have stitches, it’s important to keep your bandage dry and clean until they are removed, which is usually five to seven days after the surgery for facial wounds. This means you will have to take special care when showering.
Also, to decrease your chances of getting a black eye, we recommend you go home, sit up in a chair, and hold an ice pack on the surgical area on and off (mostly on) until bedtime that night. You should avoid bending over and lifting heavy objects for two to three days, and avoid aerobic exercise for at least two weeks.
If you don’t have stitches, you will need to cleanse the wound twice daily.
We suggest moistening a cotton-tipped applicator with 0.9 percent saline solution (easily found as contact lens solution or wound irrigation solution) and gently rubbing (not rolling) the wound with it.
After cleaning, cut out a circle of a non-stick wound dressing, such as Telfa® or Release™, and cover it with Vaseline®.
Then apply it to the wound with paper tape. You don’t need to worry about keeping the wound dry, and exercise is acceptable.
- Every three months the first year
- Every six months the second year
- And yearly until five years have passed
Goodskin Dermatology is a proud provider of Mohs micrographic surgery, an advanced technique for removing skin cancer.
Early detection of cancer greatly increases the chances for successful treatment. Call your local Goodskin office today to schedule an appointment.