Understanding Mohs surgery: A comprehensive guide

Mohs surgery is an invaluable technique in treating certain skin cancers and ensuring effective removal while preserving healthy tissue. In her latest online article, renowned consultant reconstructive and plastic surgeon Miss Charlotte Defty delves into the most commonly asked questions surrounding Mohs surgery.

Mohs surgery is a specialised technique primarily used for treating skin cancers, especially those on sensitive or critical areas like the face. It involves a meticulous process of removing cancerous tissue layer by layer and examining it under a microscope in real-time. This step-by-step approach ensures the complete removal of cancer cells while minimising unnecessary sacrifice of surrounding healthy tissue.

The procedure commences with the surgical removal of the visible tumour. This is then processed by the surgeon and slides are created to allow examination of 100% of the specimen margins.  These are examined for any cancer cells. If cancer cells are identified on any of the margins, the site involved is accurately located and a further layer is removed from this area.  This process is repeated until the cancer cells have been removed and ensures minimal impact on healthy tissue. The surgical site is then carefully reconstructed, focusing on function and aesthetics.  Since the tumour is known to have been completely removed without the need to wait for further results, the optimal reconstruction can be performed.

Mohs surgery is highly effective for treating various types of skin cancer, notably basal cell carcinoma and squamous cell carcinoma, especially when they appear in sensitive or cosmetically important areas. It’s also beneficial for recurrent or aggressive tumours and cases where preserving healthy tissue is critical.

The key advantage of Mohs surgery lies in its high cure rates while sparing healthy tissue. Its meticulous nature ensures the maximum removal of cancerous cells, reducing the likelihood of cancer recurrence and minimising scarring. Moreover, its real-time examination of tissue ensures precise tumour removal, enhancing its effectiveness.

Local anaesthesia is administered during Mohs surgery, ensuring that the patient experiences minimal discomfort during the procedure. Post-operative pain is generally mild and managed well with prescribed medication, allowing for a comfortable recovery.

Recovery from Mohs surgery is typically straightforward. Patients may experience mild discomfort, swelling, or bruising around the surgical site, which subsides gradually. Following post-operative instructions and keeping the surgical site clean are crucial for optimal healing. Depending on the complexity of the procedure, sutures may be removed within a week or two.

While Mohs surgery is considered safe, as with any surgical procedure, there are potential risks such as infection, bleeding, or unfavourable scarring relating to the site and extent of disease. However, these complications are rare and can be minimised by following post-operative care instructions diligently. 

In conclusion, Mohs surgery stands as a gold standard in the treatment of certain skin cancers, offering high cure rates with minimal impact on healthy tissue. If you have been diagnosed with skin cancer, consult with a qualified plastic or dermatologic surgeon to determine if Mohs surgery is the appropriate treatment for you.

Remember, early detection and timely intervention are crucial in effectively managing skin cancer. If you have any concerns or questions, don’t hesitate to discuss them with your doctor.