Mohs Micrographic Surgery (MMS), named for its originator Dr. Frederic Mohs, is a highly specialized surgical technique for treating skin cancer where the doctor performs the role of both surgeon and pathologist. The technique was developed in the 1930s and is currently used around the world. Mohs surgery allows for the immediate microscopic examination of the removed cancerous tissue which eliminates days of waiting for a pathology report from an outside lab.
During MMS, the entire border between the cancerous skin and your healthy skin is evaluated, giving you the highest cure rate possible. This is what "100% surgical margin evaluation" means. The MMS technique works well because cancer grows and spreads in a haphazard fashion, making it hard to differentiate from healthy skin without precise microscopic evaluation.
Mohs Micrographic Surgery Benefits
At Henghold Skin Health and Surgery Group, we perform Mohs Micrographic Surgery because of its benefits which include:
Precise removal of cancerous tissue
Maximum preservation of uninvolved, healthy tissue
The highest cure rate of all skin cancer treatments
Performed by a fellowship trained Mohs surgeon, Mohs Micrographic Surgery is the "gold-standard" for the treatment of skin cancer
How is Mohs Micrographic Surgery Performed?
Watch our video about Mohs Micrographic Surgery here or read about the process below.
First, the affected area is numbed. Then, a thin layer of tissue is removed from the surrounding skin and base. The removed tissue is mapped and sectioned by your surgeon. The tissue is taken to our in-house lab where the deep and peripheral margins (borders) of each section are thinly sliced and mounted on microscope slides. Next, your surgeon examines the tissue under the microscope.
If additional cancer is found at the margin, your surgeon notates this on the map, and the process continues until the surgical margins are completely clear.
There are two important distinctions between Mohs surgery and other techniques.
1. 100% surgical margin evaluation
2. The doctor performs the role of both surgeon and pathologist
Below are 4 steps in the Mohs process.
1. Surgical removal of the cancerous tissue
The surgeon identifies the cancerous lesion
Your affected area is anesthetized or numbed
The visible cancer and a thin margin of additional tissue are removed
2. Mapping of the tissue and surgical site, and processing the tissue
The surgeon maps, or creates a diagram, of the area
The tissue is processed and slides are prepared for microscopic analysis
3. In-house interpretation of microscope slides
The surgeon examines the tissue with a microscope, taking note of any remaining cancerous cells and precisely recording this on the map
The patient returns to the operating room in order to remove the cancerous tissue
The map directs the surgeon to the exact location of the remaining cancer, sparing precious normal skin
Mapping, slide preparation, and microscopic analysis are performed again
This process will continue until the surgeon determines that the margins are clear
4. In-house repair of the surgical defect
Once your cancer has been completely removed, your surgeon will determine the best method for repairing your wound or "defect"
In most cases, your surgeon will perform the reconstructive procedure on the same day that your cancer has been removed.
The Henghold Skin Health and Surgery Group is committed to providing the best care possible. It is important to know that not all doctors performing Mohs surgery have received the necessary training.
To be part of the Henghold Skin Health and Surgery Group, a surgeon must be Mohs fellowship-trained. Physicians who have completed an approved American College of Mohs Surgery fellowship possess the skills and expertise to perform Mohs Micrographic Surgery at all levels of complexity.
In order to receive this distinction, a physician must complete a one or two year fellowship program that includes extensive training in Mohs surgery, pathology, and reconstructive surgery. This is after completing medical school, an internship and a residency in dermatology or a related field. This level of formal education makes Mohs fellowship-trained surgeons true skin cancer experts.