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     Mohs micrographic surgery is a technique used for removing skin cancers.  The technique is named for its inventor, Dr. Frederic E. Mohs at the University of Wisconsin. Over the last several decades the technique has undergone continued evolution and is now considered the treatment of choice for the most common skin cancers under certain conditions.


     Mohs surgery is performed in the office with a local anesthetic - you do not have to go to the operating room, and you will not be asleep for the procedure. Mohs surgery is performed in stages; in the first stage, the skin cancer and a small margin of normal looking skin around it is removed. This skin is processed in our office and analyzed under a microscope by Dr. Najarian. If microscopic analysis shows that the skin cancer is all out, Dr. Najarian will reconstruct the site using plastic surgery techniques. Sometimes, however, microscopic analysis shows that the skin cancer is not all out, in which case additional skin is removed. In this second stage, the skin is again processed and analyzed under the microscope. We continue in this fashion until we know the skin cancer is all out, at which point Dr. Najarian will reconstruct the site. The average number of stages required for Mohs surgery is 2, and the average stage takes 30 minutes, but the number of stages and the time per stage can vary greatly. Time needed for surgical reconstruction varies, depending upon the complexity of the case.   


     Cure rates for Mohs surgery are very high. Published 5 year cure rates for a primary basal cell carcinoma are 99% and published 5 year cure rates for a primary squamous cell carcinoma are 97%. These cure rates exceed those attainable by radiation, excision, cryotherapy, and electrodessication and curretage (Mohs Micrographic Surgery.  Second Edition. 2004. Edited by Stephen N. Snow and George R. Mikhail. p. 45).    


     Mohs surgery and the art of surgical reconstruction are mastered during a one year fellowship sponsored by the American College of Mohs Surgery. This fellowship is typically completed after a residency in dermatology. For best results, find a Mohs surgeon who has completed this one year fellowship. 

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