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Mohs Micrographic surgery performed by Dr. Michael S. Cohen is a highly specialized treatment for the total removal of skin cancer. This method differs from all other methods of treating skin cancer by the use of Complete Microscopic Examination of all the tissues removed surgically as well as detailed mapping techniques to allow the surgeon to remove all the roots and extensions of the skin cancer.
The procedure begins after the skin is injected with a local anesthetic to make it completely numb. Then the visible cancer and a very thin layer of surrounding skin are removed with a scalpel, carefully mapped, and examined microscopically. If there is still cancer seen under the microscope, another very thin layer of skin is removed from that exact location. This may be repeated as often as necessary to completely remove the cancer.
 About Dr. Mohs
About Dr. Michael Cohen
By using these detailed techniques and complete microscopic control, the Mohs surgeon can pinpoint areas involved with cancer that are otherwise invisible to the naked eye. Therefore, even the smallest microscopic roots of cancer can be removed.
The result is:
- The removal of as little normal skin as possible
- The highest possibility for curing the cancer
Using Mohs surgery, the percentage of cure is more than 99% for most skin cancers, even when other forms of treatment offer only a 50% chance of success if previous treatments have failed.
No. Mohs surgery is performed in a pleasant outpatient surgical suite, and patients return home the same day.
Your appointment will be scheduled early in the day. Our staff will numb the area around the skin cancer. This will feel like a pinch but will not be painful because we use both refined micro-injectors and a local anesthetic solutions that causes very little stinging. The surgical procedure alone takes only 10-15 minutes. However, it takes a minimum of 30-60 minutes to prepare and microscopically examine the tissues. Several surgical stages and microscopic examinations may be required, and you will be asked to wait between stages. Although there is no way to tell before surgery how many stages will be necessary, most cancers are removed in three stages or less.
We would like to make the time you spend with us as pleasant and comfortable as possible. You may want to bring reading material to occupy your time while waiting for the microscopic slides to be processed and examined. Magazines as well as TV will be available in the waiting room area.
The most difficult part of the procedure is waiting for the results of the surgery. Since we do not know in advance how much time is necessary to remove the cancer and repair the wound, we ask that you make no other plans for the entire day that you are scheduled for surgery.
Yes, any form of treatment will leave a scar. However, because Mohs surgery removes as little normal tissue as possible, scarring is minimized. Immediately after the cancer is removed, we may choose:
- To leave the wound to heal by itself
- To repair the wound with stitches, or
- To reconstruct the wound with skin graft or flap.
This decision is based on the safest method that will provide the best cosmetic result.
Most patients do not complain of pain. If there is any discomfort, Tylenol is all that is usually necessary for relief. Avoid medications containing aspirin (see Preparing for Surgery below) as they may cause bleeding. You may have bruising around the wound, especially if the surgery is close to the eye.
Medical History: A day or two before your appointment, please complete the attached medical history form and bring it with you the day of surgery.
Medications: Continue any medications prescribed by your doctor. However, aspirin is a drug that may prolong bleeding. We ask that you avoid aspirin (including Anacin, Bufferin, Excedrin, Alka Seltzer, Percodan, Motrin, Advil and Naprosyn) for one week before surgery. If you are taking any blood thinners (Coumadin, Plavix) please call our office before scheduled surgery. In addition, alcohol will also promote bleeding, so avoid alcoholic beverages 24 hours before surgery.
Transportation: We suggest that you arrange to have a companion drive you to and from the doctor’s office. You may also be more comfortable with someone to keep you company in the waiting room.
Breakfast: The day of surgery, we suggest you eat your normal breakfast.
Be Prompt: Plan to arrive at least 15 minutes early so that a medical chart can be prepared.
Usually one return visit is all that is needed to examine the healed surgical site or to remove stitches. Afterwards, you may return to your referring physician for routine checkups.
A follow-up period of five years for the treated cancer is essential. After having one skin cancer, statistics show that you have a higher chance of developing a second skin cancer. You should have your skin checked by your referring physician al least once each year, not only to examine the treated skin cancer but also to check for new skin cancers.
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