San Diego Mohs Surgery

Mohs micrographic surgery is a specialized technique developed by the surgeon Frederic Mohs in the 1930s. Dermatologists performing this kind of surgery have specialized training.

What makes Mohs surgery superior to other techniques?
Mohs is a technique that is not only tissue-sparing, but because it allows the dermatologist to examine 100% of the surgical margin, it allows for the highest cure rate of many neoplasms of the skin, including basal cell carcinoma and squamous cell carcinoma.

What does Mohs surgery involve?
The technique involves the following steps:

• Removal of the initial layer of skin under local anesthesia.
• Mapping out the skin and surgical site for proper orientation.
• The histolopathologic component which takes approximately 30-45 minutes includes:
  • Inking the tissue
  • Mounting and sectioning
  • Tissue staining
  • Slide preparation
  • Reading the tissue specimen under the microscope.

If the margins of the first layer of tissue are free of tumor, the surgical site can undergo surgical reconstruction. If the surgical margins are positive after the first layer, the entire process is repeated with the removal of additional layers of tissue until the tumor is completely clear.

Under what circumstances is Mohs surgery indicated?

• High-risk locations including the H-zone of the face, eyelids, ears and nose.
• Large tumors.
• Recurrent tumors or tumors that were not completely removed by excision.
• Tumors with aggressive histologic profiles.
• Tumors with poorly defined margins on clinical exam.
• Cosmetically and functionally significant areas including the hands, feet and genital areas.

Because tissue does take time to process, depending on the number of layers required to completely remove your skin cancer, plan on spending up to 3 hours or more at your Mohs surgery appointment.

Should I have Mohs surgery for my skin cancer?
A discussion of this procedure with your dermatologist, along with a consideration of the other treatments for your particular form of skin cancer will help him or her determine if the Mohs technique would be appropriate in your case.