Mohs Micrographic Surgery

Mohs surgery is named in honor of Dr. Frederic E. Mohs, the physician who developed the technique in the 1930s. Mohs surgery is unique in that it combines surgical removal of the cancer with immediate microscopic examination of the tissue. This allows the surgeon to remove only cancerous skin and preserve as much healthy skin as possible, leading to the smallest possible defect and allowing for the best cosmetic outcome. For this reason, mohs surgery has the highest cure rate of all methods of skin cancer treatment and is now the gold standard for treating skin cancer on the head and neck areas of the body.

Here at Novem Dermatology, we are board certified experts in performing Mohs surgical outpatient procedures. It’s the most effective technique for removing the majority of skin cancers, including basal cell carcinoma, squamous cell carcinoma, and melanoma. This technique is most often reserved for:

• tumors that are large or with poorly defined edges
• rare high-risk skin cancers
• skin cancer that has returned after previous treatment
• skin cancer located on areas of the body where it is critical to keep the surgical incision as small as possible to obtain excellent cosmetic and functional outcomes

The procedure is done utilizing local anesthesia (safer and more cost effective than general anesthesia) in our office. After the treatment area is completely numbed, the tumor is removed and taken to our laboratory and processed into slides. We use a microscope to see if any cancer cells remain (microscopic guidance is used to decrease the likelihood of missing cancer cells not visible at the skin surface, thus avoiding large incisions that unnecessarily remove healthy skin and result in bigger scars). During this time we are ensuring that the entire cancer has been removed. If during microscope evaluation any cancer cells remain, our surgeon will go back and remove additional tissue during the same outpatient procedure.  The process is repeated as many times as necessary to ensure complete removal of the tumor. This also allows us to keep the skin site area being treated as small as possible while confirming all cancer has been completely removed. Once the tissue margins are clear, the skin site area is repaired, often with sutures (or occasionally the wound is allowed to heal on its own).

Our Mohs surgeon is also trained in facial reconstruction—each repair is individualized to the patient with the goal of giving them the best cosmetic result.

We are equipped with an on-site laboratory that immediately processes surgical specimens, allowing for real-time microscopic evaluation and immediate results to the patient.

Mohs surgery is available at Novem Dermatology with a board-certified and fellowship trained Mohs surgeon, Dr. Nicole Howe. Want to know more? Simply call Novem Dermatology at (813) 590-2120 to set up a consultation.