How is Mohs surgery done?
Mohs is offered on an outpatient basis, with local anesthesia. The cancer is removed from the patient in such a way that it can be processed in the on-site Mohs lab to reveal 99% of the margins. Dr. Betty Davis is both a board-certified dermatologist and a fellowship trained Mohs surgeon.
During the Mohs procedure, she acts as both the surgeon and the pathologist. After the tissue is processed in the on-site lab, Dr. Davis is able to examine the tissue under the microscope and trace out any roots that the cancer may have. These roots are not visible to the naked eye, and can grow in any direction like roots of a tree. If roots of the cancer are found under the microscope, the tumor is mapped and another layer that coincides to the mapping of the tumor is removed from the patient. This process repeats until the tumor is completely removed.
The Mohs process is tissue conserving because of very narrow margins that can be safely taken due to the ongoing microscopic guidance. This is critical in areas such as the eyelid, where tissue is extremely precious. This is in contrast to the traditional method of removing skin cancer with an arbitrary 3 to 10 mm margin on all sides. In traditional skin cancer excision, 1 in 20 patients will require re-excision due to positive margins on pathology. This is typically determined 3 to 5 days later. In Mohs surgery, less than 1 in 100 will have recurrence, and all margins will be clear on the day of surgery to safely proceed with reconstruction.
As you can see, there is a tremendous benefit to undergoing Mohs skin cancer excision when indicated. At Regency, we have assembled one of the leading Mohs surgeons in the nation with Dr. Davis, a CLIA certified Mohs laboratory with certified technicians, and board certified plastic surgeons to provide the highest level of care in treatment and reconstruction.