Mohs surgery and skin cancer

Q. I just went to see my dermatologist and he told me I might have a basal cell on my face. The dermatologist said that I would need to have Mohs surgery after he biopsied the lesion if it was a cancer. Can you tell me what Mohs surgery is and what I need to know to have it done?

Mohs surgery is a technique that was invented by Dr. Mohs. It is a technique that allows for the precise removal of cancer. The skin cancer is removed and examined under the microscope immediately so that all margins (areas between cancer and noncancer can be determined). This technique is done to maximize tissue conservation.

Once a patient is known to have skin cancer a patient is sent to a physician who is certified in Mohs surgery. The patient can usually undergo repair of the surgical defect with local anesthesia . By removing all the cancer the patient can then undergo a primary closure in order to have an optimal cosmetic result. Frequently a dermatologic surgeon who is a Mohs certified surgeon works with a facial plastic surgeon or plastic surgeon to complete the wound closure on the same day. Some Mohs surgeon also do the closure.

While you may have heard that Mohs surgery creates large defects, it’s really the removal of the cancer that dictates the size of the defect. I believe that your doctor has given you good advice and that Mohs surgery seems to be the best treatment for you.

Dr. Carlos Wolf is a partner at Email your questions to: