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
What are possible complications of Mohs?
As with any surgery or procedure, Mohs is associated with possible risks and complications. While it is overall a very safe and effective minor surgical treatment, there are some possible uncommon complications. Since a scar usually forms anytime you cut the skin, most patients understand and can expect some type of a scar after skin-cancer removal.
Possible risks and complications of Mohs include (but are not limited to) bleeding, bruising, wound infection, pain, unsightly scar, keloid (raised, thick scar), cosmetic disfigurement, skin discoloration, nerve damage, allergic reactions, pain, reaction to local anesthesia, widened or sunken in (depressed) scar, wound opening (dehiscence) and splitting or retained stitches, cancer recurrence, need for further surgery or treatment including radiation or plastic surgery, and rarely death.
Minor, serious, or life-threatening reactions can occur with the use of anesthetics or with medications given before, after, or during surgery. Nerves controlling muscle movement, sensation, or other functions may be damaged. This nerve damage may be permanent. Overall, most patients tolerate the minor surgery very well without any complications.
What is reconstruction? Will I have a scar?
Reconstruction is repairing or fixing the wound.
Repairing or closing the wound may involve having your surgeon stitch the wound closed side by side. Sometimes an area may heal best by letting the wound heal by itself naturally without stitches. Additional reconstruction options include using a skin graft, moving a flap of skin, and plastic-surgery closure.
Shared decision-making is very important with this issue and it can help if you are involved by reviewing how you prefer to repair the wound. Your Mohs surgeon may make some recommendations on how to close your wound.
The main goal with Mohs surgery is to remove the skin cancer first. Once the cancer is cleared out, then your Mohs surgeon will look at options of how to best fix the area. The goal of Mohs is to clear skin cancer, achieve the smallest scar, and preserve normal tissue.
In general, when you cut the skin, there will be some type of scar. Some people heal easier than others. Some scars are more noticeable depending on the location and skin type.
There are many options for treatment of surgical scars, including lasers, scar creams and gels, cortisone injections, and many other choices depending on the scar. You may want to discuss ways to help minimize scarring with your doctor at your stitch-removal appointment.
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| From top: (top) intra-op wound; (middle) sutured wound; (bottom) healed post-op site |
http://www.medicinenet.com/mohs_surgery/article.htm
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