FOR MOHS PATIENTS

World-class Training, Experienced Doctors & Caring Approach

MOHS Micrographic Surgery

If you've been diagnosed with skin cancer, your doctor might recommend a type of procedure called Mohs surgery. The goal of this procedure is to remove as much of the cancer as possible while saving the healthy tissue around it.

MOHS LPN – Glenna Parmar

Why MOHS?

 

HIGHEST CURE RATE, LOWEST RECURRENCE

Mohs provides the highest possibility of curing tumor. In previously untreated skin cancers the cure rate is as high as 99%. When a recurrent skin cancer is treated with other methods the success rate is only 80% while with Mohs surgery it is as high as 95%. Mohs has the lowest recurrence rate of any treatment method, as low as 1%.

LEAST AMOUNT OF SCARRING

Since ACMS surgeons are trained in reconstruction, it enables them to repair the skin precisely and properly and minimize scarring.

Don't delay in getting treatment - schedule your appointment today

Frequently Asked Questions:

Who provides Mohs surgery at Deerfield Dermatology Associates, Ltd.?

Dr. Singh-Behl received her MD degree at the age of 24, from an accredited six-year medical program: Northeastern Ohio Universities College of Medicine. She completed her internship in Internal Medicine and Dermatology residency at the prestigious Cleveland Clinic for four years before deciding to pursue a fellowship in Mohs micrographic surgery. Singh-Behl received her Mohs training at the Cleveland Clinic with the leaders in Mohs surgery performing surgeries on challenging and complicated cases. Moreover, Dr. Singh-Behl's preceptor learned Mohs surgery first hand from Dr. Frederick Mohs in Wisconsin. Dr. Singh-Behl is board certified in dermatology by the American Board of Dermatology, and the American College of Mohs Surgery.

Dr. Singh-Behl is a member of the American Academy of Dermatology, American Society of Dermatological Surgery and the American College of Mohs Surgery. She is affiliated with the Northshore University Health Care System hospital Group.

Members of the American College of Mohs Surgery (ACMS) are fellowshipped trained surgeons who have the expertise and experience to offer the highest potential cure rate (99%) for skin cancer and superior cosmetic results. Since ACMS surgeons are trained in reconstruction, it enables them to repair the skin precisely and properly and minimize scarring.

Why does my skin cancer need Mohs?

When considering your options it is important to understand that skin cancer that is visible represents the tip of the iceberg. Invisible cells may form roots that extend beyond the boundaries of the visible cancer. If all the skin cancer is not removed, it will recur, necessitating treatment again.

What are the most common type of skin cancer treated with Mohs surgery?

Basal Cell Carcinoma and Squamous Cell Carcinoma

What types of skin cancer warrant Mohs surgery?

  • The cancer is cosmetically sensitive areas such as the face, eyelids, lips, nose, ears, hands, feet and genitals.
  • The cancer was previously treated but has come back
  • Anatomical areas of high recurrence such as the face, ears, nose, lips and eyelids
  • Tumors that have uncertain borders or are large or aggressive

Where will I have the surgery?

MOHS surgery is an outpatient procedure performed at Deerfield Dermatology Associates, Ltd. offices and hospitalization is not necessary. Local anesthesia is injected around the tumor site so the patient is awake the entire time. The patient is able to return home the same day.

Do you have Before and After pictures of MOHs cases?

Yes, visit our MOHs before and after gallery

 

Preparing for Surgery

If you have any questions about your surgery, please feel free to give us a call. Most patients are in the office for a few hours, however we recommend that you plan for the possibility of spending four to five hours with us, as we cannot predict how long your surgery will take. Although not required, you may wish to arrange for someone else to drive you home. Aspirin (ASA) and aspirin like drugs are known to prolong bleeding. If aspirin was not prescribed by your doctor for a specific medical condition, e.g. stroke/heart disease/stent, we request that you discontinue it 14 days prior to your surgery. Aspirin-like drugs include Motrin, Ibuprophen, Excedrin, Aleve, Celebrex, Naprosyn etc. Do not restart ASA and ASA like drugs for two to three days after the surgery. Discontinue vitamin E supplements, and herbal supplements two weeks prior to surgery. Do not restart for two to three days after surgery.

Marysol Reyes, MOHS Coordinator

Surgery Day Checklist

  • Take your usual prescribed medication except for as indicated in the previous section.
  • Wear comfortable clothing that can easily be removed.
  • Take any preoperative medications that may have been prescribed to you.
  • You may want to bring someone to drive you home.
  • Plan to arrive 15 minutes prior to your appointment.

 

The Mohs surgery procedure:

The area around the lesion will be numbed. Subsequently, a layer of tissue, 1 mm beyond the cancerous skin is removed. A temporary dressing is placed. This process takes about 15-20 minutes. The tissue is carefully marked and mapped by the surgeon and taken to the laboratory where the technician processes the slides. The process of preparing the slide may take anywhere from 30-45 minutes depending on the size of the tumor. The process is repeated until all the skin cancer is removed.

After skin cancer removal, Dr. Singh-Behl will discuss post-operative repair:

  • Secondary intent healing - allowing the wound to heal on it's own if the wound is very small
  • Primary closure - closing it side to side with some stitches
  • A local flap - moving the adjacent skin to close the defect
  • A graft - removing the skin form another location to close the defect

What to expect after surgery:

  • Detailed written wound care instructions will be provided to you after the surgery
  • Most patients have mild discomfort after the procedure for which extra-strength Tylenol is usually all that is needed. Avoid ASA or ASA containing products as they increase the likelihood of post-operative bleeding.
  • Localized bruising, swelling may occur.
  • Usually one or two follow-up visits are required to remove stitches and examine the healing surgical site.

What to expect during the healing process:

Any type of surgery leaves a scar. The advantage of MOHS surgery is since the least amount of normal skin is removed, the scarring can be minimized. It takes a wound 18 months to completely heal. In the first several months, the surgical site may feel lumpy, firm, and reddened. There are various treatment options available to fully minimize the scar. These are specific to patient and the type of wound and include scar massage, topical applications of creams, cortisone injections, laser surgery and dermabrasion.