Mohs Micrographic Surgery
Precise, effective and minimally invasive.
Mohs surgery is a special type of skin cancer treatment. The procedure involves removing thin layers of skin very precisely. After each layer is trimmed away, it’s examined in our lab for signs of cancer. This process is repeated until only healthy tissue remains, leaving you cancer free with the least amount of scarring possible. Dr. Bergman has performed over 7,000 Mohs procedures and is one of the best Mohs surgeons in the country, if not the world.
Why Use Mohs?
Mohs surgery is the gold standard for treating skin cancer, particularly basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). With a 99% cure rate for certain skin cancers, Mohs surgery provides the highest level of success while minimizing scarring. The decision to use Mohs depends on multiple factors, including the type, location, size, and aggressiveness of the skin cancer.
What can I expect?
Mohs surgery is a time-intensive and resource-heavy procedure, as it requires real-time removal of a skin cancer and microscopic analysis. Plan to spend three to four hours with us on your day of surgery. Every day, there will be outlier patients that take more or less time. Depending on your unique medical background and skin cancer your pre-operative and post-operative instructions may be different. Our team will give you your tailored information.
FAQs
The best way to know if Mohs surgery is the right choice for you is by contacting us and making an appointment for a consultation. Our expert staff will walk you through your options so you can make the best and most informed decision.
On surgery day, it’s recommended to wear comfortable clothing, as well as a jacket. Since there will be downtime when skin tissue is being examined in the lab, we also recommend bringing a snack and/or reading material for use at those times.
Mohs is a highly safe procedure, but it does have risks like any other surgery. Pain, bleeding, infection and nerve damage, while rare, are possible. We will discuss specific risks to you before the procedure.
While it can go faster or longer, generally Mohs surgery takes around 3-4 hours.
After all skin cancer is removed, we will either allow the wound to heal on its own or use stitches or skin grafts to close the wound. You and your surgeon will make the decision on what’s best for your situation. If you get stitches, after one week, you will return to our offices to remove the sutures.
Whichever method is chosen, we will bandage the area. We recommend keeping the area dry and leaving the bandage on for at least 48 hours. Then you may remove the bandage, gently clean the area with warm water and soap, apply a product like Vaseline or Aquaphor, then rebandage the site. Repeat this process daily for around a week.
You may experience some discomfort or swelling for 2-3 days after the surgery. In the rare case you experience significant bleeding or infection, contact us right away.
Most patients are able to return to their normal schedule the day after surgery. However, we suggest avoiding strenuous activity if possible for at least a few days. Avoid swimming or other watersports while your wound heals as they can increase the risk of infection.
Finally, we recommend getting skin checks with us every 6 months to monitor any recurring signs of cancer.
All surgeries leave scars, but Mohs is specifically designed to minimize scarring. Any scarring will continue to lighten and improve over the course of a year after surgery becoming less noticeable over time.
Mohs Isn’t Always The Answer
Mohs is especially beneficial for skin cancers on cosmetically or functionally sensitive areas like the face, ears, nose, lips, or hands, where tissue preservation is critical. But for a small lesion on the trunk, arms, or legs, a simple excision with standard margins is often sufficient and may heal just as well without the additional steps of Mohs.
Some Skin Cancers Can Be Treated with Simpler Excisions
A standard surgical excision is sufficient for small, low-risk basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) in non-critical areas. This involves removing the cancerous tissue with a safety margin and closing the wound. For non-aggressive tumors, a simple excision can be just as effective as Mohs.
Superficial Skin Cancers May Not Require Surgery at All
Certain skin cancers, such as superficial basal cell carcinoma or early squamous cell carcinoma in situ, may respond well to non-surgical treatments like Topical chemotherapy (e.g., 5-fluorouracil, imiquimod) or electrodessication and curettage (ED&C).
These treatments can be effective for thin, superficial tumors where surgery may not be necessary.
Mohs Surgery Is Not Always Needed for Melanoma
While Mohs surgery is an exceptional technique for non-melanoma skin cancers, it is not the first-line treatment for most melanomas due to depth of invasion, metastatic potential, and the need for specialized pathology evaluation. The gold standard for melanoma remains wide local excision with appropriate margins, often supplemented with sentinel lymph node biopsy if needed.
If you’ve been diagnosed with melanoma, it’s essential to have a thorough evaluation to determine the most effective treatment plan tailored to your specific case.
