Belle Meade Dermatology

Who performs Mohs surgery?
In our office, Dr. T. Wayne Day performs Mohs surgery. He performs two cases daily, one in the morning, and then another in the afternoon. He is certified yearly by the American Society for Mohs Surgery, and is a member of the American Society for Dermatologic Surgery.”      For more information, go to:  www.mohssurgery.org.

What is Mohs surgery?
Mohs surgery is the most effective treatment for skin cancer and was invented by Frederick Mohs.  It has the highest cure rate, lowest rate of regrowth and minimizes scarring.  Mohs surgery has a five-year cure rate of up to 99% for the most common types of cancer: basal cell and squamous cell carcinomas. The goal of Mohs surgery is successful elimination of skin tumors with minimal destruction of normal skin.

How does the treatment work?
The cancer is removed layer by layer. It is examined under a microscope and mapped after each removal. This allows the surgeon to go deeper only in areas that have cancer and remove the cancer with a high degree of accuracy. The surgery itself will result in a wound, which can often be closed with
sutures or allowed to heal by itself. Some wounds may need to be closed using adjacent skin flaps or a graph.

How many treatments are required?
Mohs surgery usually involves a series of excisions performed in a single day under local anesthesia. Most cases last one to two hours. Most of this time is the testing of the specimen while the patient relaxes comfortably.

Is Mohs surgery safe?
Yes, but like any other surgery, Mohs surgery carries risks such as infection, pain, bleeding and scarring. When large amounts of tissue are removed, there can be rare cases of functional problems at the site, but these can usually be addressed through reconstructive procedures.

Are there any possible side effects?
Redness, swelling and tightness are common after surgery and are not cause for concern. Itching and loss of sensation are side effects of removing tumors. Mohs surgery has the least cosmetic damage of any surgery for skin cancer. Mohs surgeons are trained in cosmetic reconstruction as well.

Will there be any downtime?
There is downtime, as there is with any surgery. If little tissue has been removed, you may return to normal activities the next day or so.

What are the results?
The cancer should be precisely excised, with a smaller chance of regrowth than in other procedures.

What can be expected post-surgery?
You can expect a small amount of redness and swelling. A large amount of redness and itching may signal an allergic reaction, in which case you should consult your physician.

How soon will results appear?
Results are immediate, but healing takes several weeks or months.

How long does a Mohs surgery last?
The exact time will depend on the depth of the cancer. Mohs surgery usually involves several excisions, often completed in a few hours.  You will be able to return home the same day.

What conditions respond best to this treatment?
Mohs surgery is especially effective in treating basal or squamous cell types on the face or neck.  Recurring cancers on the face or other areas or  cancers with poorly-defined edges are commonly treated by the Mohs technique.

Who are candidates for Mohs surgery?
Most types of skin cancer can be treated with Mohs surgery. A consultation will determine whether you are a candidate.

How does the treatment feel?
Mohs surgery is done under local anesthesia, so you should feel no pain, although you may feel some slight discomfort.

What are the alternative treatments?
Cancers can be frozen, scraped, burned, radiated or excised with traditional surgery. Be sure to understand all your options. Your doctor will help you decide on the best course of treatment.

What are the limitations of Mohs surgery?
Mohs surgery cannot guarantee the cancer will not return and cannot prevent future cancer from appearing.

Who are the treatments provided by?
Mohs surgery is performed by specialists who have spent additional training learning the Mohs procedure and who are tested regularly for competence.

Instructions for before surgery:
Before surgery you will have a consultation which should answer any of your questions. Each cancer is different, and examination is necessary to determine what is right for you.  Dr Day will decide if any blood-thinners, such as aspirin and coumadin, should be discontinued. On the day of the surgery, eat a light meal.

Instructions for after surgery:
Most patients are not uncomfortable after surgery, but you may take pain medication if you desired.  Keep the area clean and watch for any infections. You will need to change your bandages once a day. There are some things you can do to help avoid further cancer such as avoiding sun exposure and wearing sunscreen and protective clothing. Contact your doctor immediately if you see anything suspicious, and get regular check-ups at least once a year