MOHS surgery, also known as MOHS micrographic surgery, is a surgical technique used to treat a variety of skin cancers. It has come to be recognized as the most effective surgical technique for eliminating two of the most common nonmelanoma skin cancers: basal cell and squamous cell carcinoma.
This microscopically controlled surgery involves the precise removal of layers of cancerous skin while preserving the healthy tissues. One distinct advantage of MOHS surgery compared with other skin cancer treatments is its low recurrence rate and high cure rate. It also provides the best cosmetic results, avoiding disfiguring scars or gaping wounds.
MOHS surgery is the gold standard in skin cancer treatment and is preferred over conventional options such as local excision, as it allows the surgeon to pinpoint and remove skin cancer cells on a microscopic level instead of relying on visible manifestations of the disease. Its high cure rate makes it most suitable for high-risk nonmelanoma skin cancers such as those found on the eyelids, nose, lips, and ears.
The surgery can treat the following:
In addition to the low recurrence and high cure rates, one of the main advantages of MOHS is that it offers the highest level of healthy skin preservation. Since it is microscopically controlled, the doctor is able to focus on the cancerous cells and leave the healthy cells untouched.MOHS surgery is a highly critical procedure that requires superior knowledge and skill. But most of all, it requires a thoroughness to ensure complete treatment with the lowest chance of recurrence.
As a double-boarded facial plastic surgeon whose subspecialization requires perfect attention to detail, Dr. Sedgh is supremely skilled and qualified to deliver the following results:
During your first consultation, Dr. Sedgh will take the time to evaluate the cancerous area before performing or ordering the necessary tests, such as a skin exam and a biopsy, to accurately detect and diagnose the stage level and type of skin cancer you have, as well as its severity.
Here’s what you can expect from your consultation:
Dr. Sedgh offers virtual consultations via video conferencing for patients who are located out-of-town or overseas, but you may be required to have your biopsy results on hand. Medical tourism services can also be provided to patients scheduled to undergo the procedure in his care.
MOHS surgery is usually performed in stages, depending on the size of the growth and the remaining cells after the initial surgery.
Dr. Sedgh will start by marking the margins of the skin growth as a guide for the procedure. Local anesthesia will then be administered to the area to be treated.
With a small scalpel, the doctor will carefully remove the visible portion of the skin cancer along with a thin layer of surrounding tissue before placing a temporary bandage on the incision. The removed tissues will then be sent to the laboratory for processing and examination.
In most cases, the first treatment does not always remove all of the cancerous cells, which is why Dr. Sedgh will need have the removed tissue samples examined by an onsite lab technician. The doctor will also create a map to keep track of the exact areas where tissue was removed so that if any remaining cancer is found upon examination of the undersurface and edges of the specimen, he will be able to pinpoint the exact locations of the residual cancer, allowing him maximum precision for the second treatment.
This process will be repeated as many times as possible to locate and remove all traces of cancerous cells from the affected area. Removal is done moderately and progressively to ensure the preservation of healthy tissue.
Once the microscopic examination reveals that all tissue samples are clear of cancerous cells, the surgical area is ready for repair, which involves a procedure known as cancer reconstruction.
The entire surgery can take a few hours up to an entire day in rare cases, but this would depend on the size and severity of the skin cancer.
MOHS is normally performed as an in-office outpatient procedure. Following the treatment, Dr. Sedgh may immediately perform cancer reconstruction surgery on the same day to restore the appearance of the skin. If the patient chooses to wait before deciding on reconstruction, he may temporarily close the wound and allow it to heal on its own.
As with any surgery, you will be provided with detailed instructions for proper wound care. This ensures the prevention of infection and permanent scarring. Your doctor may also recommend that you temporarily refrain from bathing to avoid getting the area wet, and to stay indoors to avoid unnecessary sun exposure.
The recovery time varies depending on the size and location of the skin cancer, as well as the complexity of the surgery. Patients can expect localized swelling and itching for the first few days, as well as redness (which should gradually fade in the course of 4-6 months).
Dr. Sedgh will schedule several follow-up appointments over the next few weeks to ensure that your wound is healing properly. He will also encourage regularly scheduled skin exams to check for any new growths, although the chances of recurrences are quite minimal with this technique.
“My experience with this doctor has been excellent. The healing process has been really great and he positioned the excision and repair on my cheek so well that the excision is barely visible already and it has only been a couple of months. I am very happy with the care I am receiving from him.
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