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A skin cancer diagnosis can be a scary and stressful time, but treatment is possible and new technologies have greatly improved outcomes. Our Fellowship-Trained Surgeons, Dr. Joseph L. Cvancara, Dr. Courtney Gwinn, and Dr. Chadd J. Sukut are experts in a leading outpatient procedure called Mohs Micrographic Surgery, a cutting-edge technique that sees cure rates as high as 99%. Read on to find out more about Mohs Surgery, its results, and whether it’s the right treatment for you.

What is Mohs Surgery?

Mohs Micrographic Surgery is a specialized procedure that removes skin cancers at the microscopic level.

Mohs Surgery allows surgeons to examine and remove skin tissue using an intricate level of precision and control, eliminating the need to estimate how deep a tumor’s roots extend or how much to cut. They can see first-hand exactly where the cancer goes, and where it ends, and are able to remove all of the cancerous cells, layer by layer, while keeping as much healthy tissue intact as possible. 

Working at the microscopic level also results in minimal scarring, so Mohs Micrographic Surgery is also ideal for skin cancers on highly visible areas, like the head and neck.

The procedure was developed in the 1930s by Dr. Frederic Mohs, who combined the surgical removal of cancerous tissues with the immediate microscopic examination of the tumor and its underlying roots. Today, it’s the single most effective technique for removing basal and squamous cell carcinomas, with a cure rate of up to 99%.

What to Expect with Mohs Surgery

Mohs Surgery is performed by our highly qualified Mohs fellowship-trained doctors as an outpatient procedure, under local anesthesia and rarely requires hospitalization. It has a superior cure rate for skin cancer and is often considered even after a prior treatment has failed. However, it is important to understand that no method at any time, including Mohs Surgery, can promise 100% cure rates.

The Mohs technique allows surgeons to cut away the maximum amount of the tumor while leaving the surrounding normal skin largely untouched. This leads to reduced scarring in highly sensitive or visible areas, and results that are significantly better vs. conventional treatments. In fact, Mohs Surgery has a high cure rate of 95% to 99% (vs. cutting out, scraping and burning, and radiation. 

When performing the procedure, our Fellowship-Trained Mohs Surgeons follow a strict protocol that’s been perfected over decades and includes:

  1. Examining the roots of the skin cancer. Much like the tip of an iceberg, a tumor’s roots may extend beyond its visible portion. If these roots aren’t removed, cancer will likely recur.
  2. Removing the visible portion of the skin cancer surgically.
  3. Color-coding the removed tissue with a dye, dividing it into sections, and drawing a map.
  4. Examining the undersurface and edges of the tissue under a microscope in order to ensure that all the skin cancer is out.
  5. Marking the exact area on the map where any skin cancer persists in order to remove another layer of skin from precisely, and only, those areas. 

The process continues until there is no longer any evidence of skin cancer remaining. At this point, the surgeon will close the wound in a way that leaves the least scarring possible.

What Types of Skin Cancer Does Mohs Surgery Treat?

Basal cell carcinoma and squamous cell carcinoma are the two most common types of skin cancer that are treated using Mohs Micrographic Surgery. Melanoma in-situ can also be treated with Mohs Micrographic Surgery. While finding a new skin cancer growth isn’t usually considered an immediate threat, it should be removed as soon as possible.

We recommend this because regardless of its type, skin cancer will not go away on its own. It can, and often does destroy the skin and structures where it grows.

Skin cancer can be fatal if left untreated. The longer a skin cancer is left untreated, the larger it grows and increases the risk of it spreading through the body.

Read more about skin cancer here.

Does My Insurance Pay for Mohs Surgery?

In most cases, your medical insurance will cover Mohs Micrographic Surgery, although you may be responsible for any deductible or copayment required by your policy. If possible, we arrange for your insurance company to reimburse us directly. 

If paying for your Mohs Micrographic Surgery is a hardship, please let our Advanced Dermatology & Skin Surgery team know, and we’ll be happy to work out an alternative payment plan. Additionally, if you are a Medicare enrollee, be sure to mention any special supplemental policies. Please bring all health insurance cards and policy numbers with you when you come in for your appointment. 

Read more about Insurance information here.

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