The most effective surgical method for skin cancer removal is Mohs micrographic surgery. It has the best chance of complete removal and it creates the least scarring. Developed in the 1930s by Frederic Mohs, it became the standard in dermatology in the 70s and 80s. It involves taking the known cancerous growth along with some of the bordering tissue. The tissue is then examined immediately under the microscope for signs of remaining cancer. The border continues to expand as necessary until the border tissue is cancer free. Mohs surgery preserves the greatest amount of normal tissue and provides the foundation for the best skin reconstructions while limiting scarring and permanent disfigurement.
During the procedure, Dr. Kovacs removes one thin layer of tissue at a time. While the layers are removed, the margins of the tissue are studied under a microscope for the presence of cancer cells. If the result of the microscopic study shows that the margins are cancer free, then the surgery ends. If there are cancer cells present in the tissue, more tissue will be removed from where the cancer cells were found. The procedure repeats itself until the margins of the tissue sample show that they are free of cancer. Mohs micrographic surgery eliminates any guesswork in the removal of skin cancer and can produce some of the best therapeutic and cosmetic results.
Mohs micrographic surgery has the highest overall cure rate for primary skin cancer removal — from 94 to 99 percent. The cure rate is slightly lower for secondary or recurrent cancers. Mohs micrographic surgery is the most effective method known for the removal of non-melanotic skin cancer throughout the world.
Although it can take longer than simple excision and suturing, the incredible success rates for Mohs procedures make it the best option if applicable. The initial excision may take just 10-15 minutes, but then the tissue needs to be examined under the microscope. This process continues until the border tissue is clear of cancer cells. Mohs procedures usually take several hours.
Your recovery is no different than with other surgeries. If the excision site was simply closed with side-to-side suturing your recovery is pretty straightforward. But, depending on the size of the growth and removal of tissue, grafts or a skin flap may be required. These will lengthen your recovery.
While Mohs surgery preserves as much healthy tissue as possible and maximizes the options for repairing the area, any incision leaves a scar. You can’t judge the initial appearance of your scar too harshly, as scars can take up to a year or more to fully mature. Initially, the scar will likely be reddish, and it may appear bumpy, but the color will fade and the scar will soften with time. Dr. Kovacs has extensive experience with skin cancer removal and Mohs best practices, ensuring your scarring will be as minimal as is possible.