Mohs Surgery Frequently Asked Questions
Mohs Micrographic Surgery is a specialized treatment for certain types of skin cancer that combines the surgical removal and immediate microscopic examination of the tumor and entire surrounding tissue margin. The technique allows for the immediate identification and removal of the entire tumor layer-by-layer until the cancer is completely gone.
Is Mohs Surgery a new treatment?
No, Mohs Surgery has been performed for decades. Mohs Surgery is named after Dr. Frederic E. Mohs who developed the technique. Dr. Mohs recognized that skin cancer often resembles the “tip of the iceberg” with tumor cells surrounding the visible tumor that can only be seen under the microscope. Dr. Mohs treated his first patient using the technique in 1936 at his office in Madison, Wisconsin. Since then, technical improvements have been made to the procedure; but the general premise has remained the same.
Is Mohs Surgery the best treatment option for all skin cancer types?
Always see your dermatologist if you have any suspicious skin lesions. More than likely your dermatologist will perform a biopsy. If the biopsy tests positive as cancerous, depending on the type and location of the skin cancer (along with other factors) your doctor may recommend Mohs surgery as the best option for treatment. If your current physician does not perform the treatment it is likely you’ll be referred to a Mohs surgeon in your area.
Does Mohs Surgery leave a scar?
All surgical procedures have the potential for some degree of visible scarring. The appearance of the post-Mohs procedure scar depends on various factors including the location and size of the final surgical defect, the patient’s individual skin characteristics, and available reconstruction options.
A benefit of the tissue-sparing nature of the Mohs technique is to produce the minimum possible surgical defect, thus benefitting the resultant scar. The procedure may allow for smaller and less noticeable scars than other skin cancer removal options.
The Mohs surgeon may be able incorporate suture lines into the patient’s natural skin lines and folds. Most scars improve in appearance naturally over time, and future scar revision techniques may employed if necessary.
If my skin cancer is located in a very noticeable area should I have a plastic surgeon perform the procedure?
It is important to have the skin cancer removed by a fellowship-trained Mohs surgeon due to the histopathology component of the procedure. A fellowship-trained Mohs surgeon also has extensive training in post-Mohs reconstruction. If based on the size and location of the surgery there is additional concern regarding the closure, your dermatologist/Mohs surgeon may refer you to a plastic surgeon to perform the closure following Mohs surgery.
What type of training does a Mohs surgeon receive?
After completing a residency in dermatology, a physician can apply to participate in a fellowship training program approved by American College of Mohs Surgery (ACMS) in Micrographic Surgery & Dermatologic Oncology (Mohs). The fellowship training lasts one to two years, depending on the particular program, with the purpose of safeguarding standards by ensuring that fellows-in-training are properly trained and acquire the necessary expertise to perform Mohs surgery. You may search for a fellowship-trained Mohs surgeon on the ACMS website: http://www.mohscollege.org/
Will Mohs surgery be covered by my medical insurance plan?
Most insurance plans (including Medicare) will cover Mohs surgery. Contact your insurance company directly to learn more about your specific plan coverage.
Because the Mohs procedure is a multi-step and highly specialized technique, it does tend to have a higher cost than some other treatment options. However, it is important to consider the benefits of Mohs including its lower recurrence rate and ability to spare more healthy tissue.