Mohs Surgery (cont.)
Nili N. Alai, MD, FAAD
Dr. Alai is an actively practicing medical and surgical dermatologist in south Orange County, California. She has been a professor of dermatology and family medicine at the University of California, Irvine since 2000. She is U.S. board-certified in dermatology, a 10-year-certified fellow of the American Academy of Dermatology, and Fellow of the American Society of Mohs Surgery.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is Mohs micrographic surgery (MMS)? Why is the procedure called Mohs?
- Where can I have Mohs surgery, and how long does the surgery take?
- What kind of physician can perform Mohs surgery? Where can I find a doctor board-certified in Mohs?
- Is Mohs only for skin cancer?
- Am I a good candidate for Mohs surgery?
- What if I have artificial joints or other health issues?
- What areas are treatable by Mohs surgery?
- What are possible complications of Mohs?
- What is reconstruction? Will I have a scar?
- What are alternatives for Mohs surgery?
- What about insurance coverage and costs?
- How do I prepare for my surgery?
- How is recovery? Is it painful?
- How do I take care of my surgical area after Mohs surgery?
- What is the chance that my cancer will recur?
- How many "levels" of Mohs will I need?
- How are skin cancers treated?
- Find a local Dermatologist in your town
Is Mohs only for skin cancer?
Yes, Mohs is a widely used method of surgically removing the most common types of skin cancers, including basal cell carcinoma and squamous cell carcinoma. It is currently not used to remove noncancerous growths. Less frequently, Mohs may also be used for other malignant tumors. In special cases, Mohs may be used to surgically treat malignant melanoma, lentigo maligna, dermatofirosarcoma protuberans, Merkel cell carcinoma, microcystic adnexal carcinoma, malignant trichoepithelioma, angiosarcoma, atypical fibroxanthoma, and other cancerous skin tumors. However, most Mohs surgeons treat primarily basal and squamous cell cancers by this technique.
Am I a good candidate for Mohs surgery?
You may not be a good candidate for Mohs if you are unable to tolerate local anesthesia, have extreme anxiety, have a surgical phobia, or are in very poor health.
Your decision on the best treatment choice may depend on different factors such as the location and type of skin cancer, your past treatments, your overall health, and level of comfort with the procedure. Your physician can help you sort through the different treatments and assist in your shared decision-making process. However, the right decision for you is always yours and your doctor's to make.
What if I have artificial joints or other health issues?
Your Mohs surgeon needs to know of any underlying medical conditions that may affect your surgery or wound healing. You would want to be certain to tell your surgeon beforehand if you have any artificial parts (implants) like knees or hips, a pacemaker or defibrillator, or need to take antibiotics before dental procedures because of a heart condition or murmur.
Your Mohs surgeon needs to know if you have had a history of "Staph" or other skin infections in the recent past. You may be asked to wash with a special antibiotic soap or wash like Hibiclens (chlorhexidine) the night or morning before surgery to help reduce the number of bacteria on your skin.
Patients need to also advise their surgeon of any drug allergies to anesthetics like lidocaine (Xylocaine), or novocaine. Additionally, the surgeon may need to know of any bleeding or bruising tendencies, hepatitis, HIV/AIDS, or pregnancy.
Learn more about: Xylocaine
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