Skin cancer is the most common type of all cancers and is estimated to affect one in five people. If left untreated, it can spread and quickly become life-threatening.

Fortunately, skin cancer is highly treatable with Mohs micrographic surgery, which has a success of up to 99%. At New York Laser & Skin Care, we’ve been carrying out this noninvasive procedure for twenty years with excellent results, helping countless patients live cancer-free.

If you’ve been diagnosed with skin cancer, we’re here to help you achieve a full recovery with a safe, highly effective treatment. Book a consultation with us today, and let us put your mind at ease and restore your health.

How Mohs Micrographic Surgery Works

Mohs surgery is typically used to treat squamous and basal cell carcinoma, the two most common forms of skin cancer. This surgery is known for delivering the highest chance of a complete cure with the lowest rate of cancer recurrence.

Mohs micrographic surgery is a procedure in which a tool, called a curette, is used to precisely strip away cancerous skin tissue one layer at a time. Each layer is brought into our clinic’s laboratory and examined for cancer cells; the process is repeated until the final layer of removed skin is found to be completely cancer-free. 

Mohs surgery is designed to remove the malignant tissue while maintaining as much healthy tissue as possible to facilitate wound reconstruction and to enable an aesthetically pleasing outcome.

In contrast, other surgical skin cancer treatments, such as excision, unavoidably result in a significant margin of healthy skin tissue being removed.

Outlook

Mohs surgery has an extremely high success rate—up to 99%—the highest of any available skin cancer treatment. However, all patients who developed skin cancer face an increased risk of cancer recurring in future.  After a successful procedure, it is vital to visit your family doctor once or twice a year to monitor for signs of new cancer development.

When Should You Consider Mohs Surgery?

Mohs surgery is highly recommended in the following situations:

• You’ve been diagnosed with nonmelanoma skin cancer or your cancer has recurred following treatment
• Your treatment area is large or has poorly defined edges
• You want all malignant tissue to be removed fully in one session
• You want to preserve as much healthy tissue as possible
• You want to ensure an aesthetically pleasing final result

What to Expect From the Procedure

On the day of your appointment, ensure you have a clear schedule, as there is no way to determine how long the procedure will last. 

Bring something to occupy yourself with and wear comfortable, loose-fitting clothes. If you regularly consume alcohol or take blood- thinning medications, you will be advised to stop a few days before your appointment.

Once comfortably seated in our operating room, our specialist will mark your treatment area with a pen and inject a local anesthetic. You will be fully awake, but will not feel any pain or discomfort whatsoever during this procedure.

Our specialist will then begin by removing a thin layer of tissue from the treatment area with a curette. One of our technicians will place this tissue on a glass slide and examine it in our laboratory. They will create a diagram mapping the locations of cancer cells to understand where to remove the next layer. While they work, you will be free to relax in the patient lounge.

Our specialist will then invite you back into the operating room and remove another layer of skin to examine. This process is repeated until the final layer of skin removed is found to contain no cancer cells at all. At this point, the procedure will be complete. Your wound will then be reconstructed and bandaged at which point you will be free to leave.

The first day after your surgery, be sure to rest and avoid any strenuous activity. Keep your wound bandaged for 24–48 hours and apply ice as needed to reduce pain. We will provide you with personalized aftercare instructions to follow, advise you on which medications to take to help manage discomfort and prescribe antibiotics to help prevent infection.

Wound closure

Following surgery, a wound will remain in the shape and size of the removed cancerous tissue. It can be as small as the head of a pencil eraser and is typically easy to reconstruct and suture.

Our founding director, Dr. Kauvar, personally handles wound reconstruction in 90% of cases, immediately after the procedure. However, if the treatment area is particularly large, it will require major reconstructive work; in this case, we will temporarily close your wound and refer you to a specialized plastic surgeon to complete the process.

Results

The results of Mohs micrographic surgery are immediate, with all the cancerous tissue removed. 

After surgery, the wound will scab and occasionally bleed; this is an expected step in the healing process. It will fully heal after about 4–6 weeks and leave a scar. This scar will fade slightly after the first few months, but will likely remain.

For those who wish to undergo scar revision, we also offer laser scar removal services.

What Are the Risks?

Common adverse effects of Mohs surgery include bleeding, discomfort and tenderness around the treatment area. If a large tumor is removed, there is also a possibility that some sensory nerves will be cut during the procedure. This can lead to temporary numbness or lack of muscle strength around the surgical site. While these effects can take some time to resolve, they are expected to regrow with normal sensation returning.

A more serious risk is the possibility of infection, which you can avoid by not touching your wound while it is healing and carefully following your provided aftercare instructions. As with any procedure involving anesthesia, there is also a risk of allergic reaction; our specialists will assess this risk during your consultation.

FAQ

How long will the procedure last?

A Mohs surgery procedure typically lasts 4 hours or less, but can take considerably longer if the cancerous tissue is extensive. Wound reconstruction usually then takes an additional 2–4 hours to complete.

Will follow-up office visits be necessary?

Follow-up visits are very important to ensure your wound is healing properly and the cancer has been fully eliminated. You will need to return to the clinic for a follow-up one month after your procedure. 

What are some alternatives to Mohs surgery?

If Mohs surgery is not right for you, you may wish to explore the following treatment options:

• Radiation therapy uses proton or X-ray beams to kill cancer cells and is highly effective at treating aggressive forms of cancer
• Cryosurgery destroys cancer cells by freezing them with liquid nitrogen and is effective in treating basal cell carcinoma, a cancer that affects the skin’s superficial layers
• Photodynamic therapy uses photosensitizing drugs to render cancer cells vulnerable to light and then destroys them with powerful pulses of light energy

Can Mohs surgery treat melanoma?

Mohs surgery can successfully treat early melanoma but only lentigo melanoma, a cancer that affects surface skin tissue. Once the cancer advances, a different treatment strategy is needed.