What is Mohs micrographic surgery?
This sort of surgery refers to a specialised technique whereby skin cancers are removed in a staged manner. This results in accurate removal of skin cancer without removing excessive normal skin. We use this technique to minimise scarring and reduce the risk of recurrence of the tumour.
Why do I need this surgery?
Mohs surgery is recommended to patients with tumours in difficult sites on the body (on the face, hands or genitals) in order to give you the most accurate way of removing the tumour fully and give you the least chance of it coming back. This has the added benefit of ensuring your scars will be the smallest possible and will give you the best cosmetic result.
What does the appointment involve?
Mohs surgery is a staged procedure which means that it is difficult to give you a firm time frame of how long the procedure will take as it depends on how many stages the surgeon will have to take to fully clear your tumour. Most Mohs surgeons will clear the tumour at the ‘first stage’ in around 70% of cases. However, if your tumour is larger than expected then your procedure (more stages) will take longer and you should plan to be in our department for at least half a day and possibly longer. Mohs surgery has the added advantage of getting your results within 30 minutes of the procedure (rather than waiting days), i.e. we can tell you whether your tumour is fully removed or not on the day so there is no waiting for results.
We recommend bringing entertainment such as a book or a media device in order that you are entertained and kept occupied during the stages of this procedure. Keeping yourself well hydrated and bringing your favourite foods is also recommended to keep you more comfortable.
How is Mohs surgery done?
Mohs surgery is usually performed under local anaesthetic which means that you will be awake for the procedure and we will use a long-acting anaesthetic so that your procedure will remain pain free from the initial injection. We take the sample of skin to our lab which is next door to the theatre and the analysis begins. You will have a dressing applied and then wait for your results. If clear then we will then discuss the best way to close the wound, this is usually done on the same day. Sometimes we will refer onto another surgeon for the closure.
Is there any recovery time afterwards?
Recovery time depends on how complex your procedure is and what sort of reconstruction you have had. In general most procedures will heal within one to two weeks. Your Mohs surgeon will discuss with you the most likely reconstructive option that you will have on the day and your healing time thereafter.
We recommend having a few days off work at least, possibly a whole week in order to give yourself a chance to fully recover following the procedure. You will not be able to do any exercise for at least a week following the procedure. Swimming, heavy lifting, and gardening are also not recommended for at least two weeks following the procedure.