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Mohs surgery

Mohs micrographic surgery, a highly effective and advanced treatment for skin cancer, is available in San Angelo.

Mohs micrographic surgery was originally developed in the 1950s by Dr. Frederic E. Mohs. Since Dr. Mohs' breakthrough development, the procedure has become the most effective, advanced and precise treatment for a variety of skin cancers.

The procedure is unique among skin cancer treatments and has multiple advantages—including a 99 percent cure rate. The primary goal of Mohs surgery is to remove all cancerous cells while leaving healthy tissue intact helping to minimize scarring and giving the optimal cosmetic repair.

How does Mohs surgery work?

Mohs is an outpatient procedure and is performed in the office setting. In most cases, surgery begins in the morning and is completed the same day, depending on the extent of the tumor and the amount of reconstruction necessary. The patient is awake throughout the procedure. A local anesthetic is used to numb the area around the tumor. 

Once numbed, the surgeon removes the visible pieces of the tumor and a thin layer of surrounding tissue. The tissue is processed in a special technique and slides of the tissue are rapidly produced. The layer is placed on a slide, stained and examined by the Mohs surgeon under a microscope. If signs of remaining cancer are evident, another layer of tissue is removed precisely from the area where the cancer was detected. This is how the surgeon ensures only cancerous tissue is removed. These steps are repeated until the surgeon views a sample that is free of cancerous tissue. Generally, most tumors require one to three stages for complete removal. View an infographic of the procedure.

What happens after surgery?

After surgery, the wound is assessed and the surgeon discusses reconstruction options with the patient. Various repair options are possible, including simple closure, flaps, grafts and even allowing a wound to heal on its own. In most cases, these techniques are the same as performed by plastic surgery. Each wound is unique and the best repair is chosen for a given defect. The surgeon nearly always performs these plastic surgery repairs on the same day as tumor removal.

 Another advantage of Mohs surgery is that the procedure can be used to cure skin cancer when other treatment methods have failed. Some other methods do not employ the precise identification for the removal of cancerous tissue. Therefore, healthy skin may be removed unnecessarily or the tumor may regrow if any of the unidentified cancerous tissue is left behind. The Mohs technique is mainly utilized in the treatment of basal cell carcinoma and squamous cell carcinoma, the most common types of skin cancer, but can also be used on other less common skin cancers.

What training does a Mohs surgeon receive?

A fellowship-trained Mohs surgeon completes an extensive fellowship that requires at least one full year of training and hands-on experience after completing their dermatology residency. Mohs surgery specialty training educates physicians in the areas of cancer surgery, pathology and reconstructive surgery. Mohs surgery is unique in that the same physician is able to perform all these steps.

Mohs surgery is certainly an excellent option for skin cancer treatment. But, there are ways to help prevent skin cancer. Along with using sunscreen as protection, avoiding sun exposure when possible and performing outside activities early and late in the day can reduce your risk of sun damage. Early detection of skin cancers by regular skin self-exams to look for warning signs can allow for the optimal cure of skin cancers.

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