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Understanding Mohs Surgery in St. Louis

Updated: Apr 1, 2023


Mohs surgery procedure in St. Louis
Mohs surgery procedure in St. Louis

What is Mohs surgery?


Mohs surgery is a surgical technique used to treat certain types of skin cancer. It involves removing the skin cancer one layer at a time and examining each layer under a microscope until no cancer cells remain.


Mohs surgery allows for the complete removal of cancerous tissue while sparing as much healthy tissue as possible. Other surgical methods may remove healthy tissue along with the cancerous tissue, leading to larger scars or cosmetic deformities.


Mohs surgery is performed under local anesthesia in an outpatient setting. During the procedure, the Mohs surgeon removes the skin cancer with a narrow margin of normal tissue. The tissue is then examined under a microscope to determine if any cancer cells are remaining. If cancer cells are found, the Mohs surgeon excises another layer of tissue and examines it under a microscope. This process is repeated until no skin cancerous cells remain.


Once the skin cancer has been completely excised, the Mohs surgeon will perform reconstructive surgery to restore the appearance of the area. This is usually performed on the same day.


Mohs surgery is highly effective at treating certain types of skin cancer, with cure rates exceeding 95%. It is particularly useful for cancers located in cosmetically sensitive areas, such as the face, where minimizing scarring is important.


Who performs Mohs Surgery?


Mohs surgery requires extensive training and expertise to perform. It is typically performed by dermatologic surgeons, who are specifically trained in the diagnosis and treatment of skin cancer.


To become a Mohs surgeon, a physician must undergo specialized training and certification. This typically involves completing a fellowship in Mohs surgery and cutaneous oncology, which is a one-year training program that focuses exclusively on the diagnosis and treatment of skin cancer.


During the fellowship, the physician receives hands-on training in performing Mohs surgery, as well as training in the interpretation of pathology specimens. The fellowship also includes didactic training in skin cancer management, including the use of topical chemotherapy and immunotherapy.


After completing the fellowship, the physician must pass a certification exam administered by the American Board of Dermatology.


Preparation for Mohs Surgery


Before undergoing Mohs surgery, patients will typically have a consultation with their Mohs surgeon. During the consultation, the surgeon will evaluate the skin cancer and determine if Mohs surgery is the appropriate treatment. The surgeon will also discuss the procedure with the patient and answer any questions they may have.


Patients may be asked to stop taking certain medications prior to the surgery, including blood thinners and anti-inflammatory drugs. They would also be counseled to avoid alcohol and smoking in the days leading up to the surgery.


On the day of the surgery, patients should wear comfortable clothing and avoid wearing jewelry or makeup. They should arrange for transportation home after the procedure, as they may not be able to drive themselves.


Post-operative Care and Recovery


After the procedure, patients will be given detailed instructions on how to care for the surgical site and what to expect during the recovery period. Patients may experience pain, swelling, and bruising in the area, which is typically managed with ice packs and anti-inflammatory/pain medications.


Patients should avoid strenuous activity and heavy lifting for several days after the surgery. They should also keep the surgical site clean and dry and avoid exposing it to sunlight.


Patients will typically return to the Mohs surgeon in 7-14 days to ensure proper healing and remove any sutures that may have been placed during the reconstruction procedure. Patients will be counseled to continue seeing their dermatologist for ongoing skin cancer surveillance.

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