Each year, more than 1.2 million Americans are diagnosed with skin cancer. While skin cancer is not always life threatening, it can progress if left untreated. DermSurgery offers the most advanced treatment for skin cancer – Mohs micrographic surgery. This procedure offers the greatest potential for cure while minimizing the cosmetic impact on the patient.
A world-renowned Mohs surgeon for over two decades, Leonard H. Goldberg, M.D., DermSurgery’s Medical Director, specializes in this procedure. In addition, he serves as the Program Director for the ACGME accredidted Procedural Dermatology Fellowship – training upcoming Mohs surgeons. As Mohs surgeons, our physicians have extensive training in three specific areas: dermatologic surgery, pathology (interpreting microscopic slides) and reconstructive surgery.
This highly innovative and successful procedure involves removing the tumor, along with a very thin layer of skin tissue, which is immediately frozen and microscopically examined for cancer cells. If cancer cells are found, an additional thin layer of tissue from that very specific area of concern is removed and microscopically examined for cancer cells. If evidence of disease exists, the process continues, as layer by layer the cancer is traced out until it is completely gone. With Mohs surgery, only affected skin is removed, preserving as much of the surrounding healthy tissue as possible, thus minimizing the cosmetic impact. Mohs surgery is performed under local anesthetic as an outpatient procedure.
Mohs surgery is very effective for skin cancers that:
- Are located in cosmetically sensitive areas, or areas that are essential to functioning – such as skin around the ears, nose, lips, and the scalp
- Have been previously treated (recurrent)
- Are large and difficult to treat
Our goal at DermSurgery is to ensure your total comfort and understanding of any surgery, so following is a detailed outline of this procedure:
Your Preoperative Visit
Prior to scheduling the surgery, you may visit with the doctor, who will answer any questions you have and will discuss the procedure in greater detail. He will examine your skin cancer, obtain your medical history and make an assessment to determine the most beneficial and effective treatment of your skin cancer.
Our goal at DermSurgery Associates is for you to be as comfortable, relaxed and informed as possible. So we recommend that you read all information we provide to you regarding the procedure, ask questions and follow the pre-op guidelines given to you during your first visit. Prior to surgery, it is important to be well rested, to eat a good breakfast and to plan to spend a few hours at our facility. We also suggest that someone accompany you to drive you home.
Your doctor will be assisted by a team of nurses, medical assistants, and technicians who will be directly involved in your care. The procedure begins with the cleansing of your skin. We then numb the area with local anesthetic and remove the tissue. After the tissue is removed, we process it in our laboratory, which usually takes about 45 minutes. If the microscopic examination reveals signs of any additional tumor, we will continue the process, removing only residual tumor and sparing the healthy skin. Most skin cancers are completely removed in two or three surgical stages.
You and your physician will discuss reconstruction in the preoperative visit. However, the actual method is determined only after the skin cancer is completely removed and the doctor can make a final assessment. Depending on the size and location of the defect, the doctor will decide on the most aesthetically pleasing type of repair.
Post Surgical Care
In order to facilitate the healing process, it’s very important to take good care of yourself following your procedure. DermSurgery Associates will provide you with detailed information on how to care for your wound in the weeks following surgery. However, you should plan on wearing a dressing for approximately one to two weeks, while avoiding any strenuous activities.
Your surgical scar will heal in one to two weeks. Immediately following surgery, you may experience minimal pain, which can be relieved with Tylenol™. Significant blood loss following this type of surgery is rare, but if you experience bleeding, please contact our office. The area may feel swollen or even lumpy, especially during the first few months.
We will make periodic follow-up appointments for you until your wound has healed. It’s important to know that once you have developed a skin cancer, you are more susceptible to developing additional skin cancers in the future. If you notice any suspicious areas, contact your doctor for an evaluation.