Mohs Surgery

Mohs surgery provides the highest cure rate for non-metastasized skin cancers, with the best cosmetic result. This advanced technique involves removing the visible cancer, then examining the removed skin under a microscope. The cancer is carefully mapped so the surgeon can remove cancerous cells while leaving most of the adjacent tissue.

Dr. Stephen Spates is the director of Mohs surgery at The Derm Group. He is a board-certified dermatologist who completed a fellowship in Mohs Micrographic Surgery and received specialized training in cosmetic closures, enabling him offer the most desirable cosmetic result available. Dr. Spates is sought out by many local dermatologists and surgeons as a consultant and expert.

Understanding Your Treatment

Around the world, Mohs surgery is recognized as the most precise method of skin cancer removal because it virtually eliminates cancer cells while causing minimal damage to the surrounding skin. This advanced treatment is especially effective in treating recurrent and aggressive cancers, as well as those on cosmetically sensitive areas, such as the face. Extremely high cure rates (97-99%) can be achieved with this treatment.

What is Mohs micrographic surgery?

Mohs surgery involves removing skin cancer and examining the affected tissue under a microscope. The skin cancer is carefully and completely mapped until all areas are shown to be free of any tumor. The main difference between Mohs micrographic surgery and traditional methods of treating skin cancer is this immediate microscopic control.

When is Mohs micrographic surgery indicated?

In addition to treating recurrent cancer and cancer in cosmetically sensitive areas, other considerations in choosing Mohs micrographic surgery include:

  • an invasive or aggressive appearance under the microscope
  • an excessively large or very deep tumor
  • any tumor with poorly defined borders that are difficult to see.

How is Mohs micrographic surgery performed?

The first step involves removing the visually apparent tumor with a surgical scalpel. The tissue sample is then cut into pieces. Each piece is color-coded and systematically mapped onto a precise diagram of the site so that a carefully created depiction of the tumor area and the pieces of removed skin can be constructed. A trained Mohs histotechnician then prepares frozen sections of these tumor pieces under the supervision of the Mohs surgeon. The tumor is removed and the tissue is processed in such a way that the depth of the tissue submitted and the most peripheral skin edge will be available for microscopic examination. If the residual tumor is identified, additional stages are undertaken until a cancer-free plane is achieved.

Please also read our pre-operative instructions for Mohs surgery.

Where can I learn more about Mohs surgery?

For more information about preparing for Mohs surgery and what to expect, please read our patient information handout. Additional information is also available at the American College of Mohs Surgery website and on their Patient Education website.

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