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Mohs Surgery Definition

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Updated June 29, 2009

Definition: also known as Mohs' micrographic surgery (MMS) and named after a Wisconsin surgeon named Frederic Mohs, this surgical technique is used when skin cancer is similar to an iceberg -- the cancerous cells cover a considerably larger area beneath the skin than what is seen on the surface. It is also typically a technique used when the lesion does not have well-defined borders. Both dermatologists and plastic surgeons can perform this surgery.

The Mohs technique consists of meticulously removing cancerous tissue one layer at a time. After removal, the specimen's surface area is examined under a microscope. If there are any cancer cells seen at the outer edges of the specimen, more of the surrounding tissue is removed and the process is repeated until the sample's margins are examined and come up OK.

If, on the other hand, no cancerous cells are found on the outer edges of the tissue, only a small wound is left. This technique eliminates the guesswork from determining tumor margins, and is less likely than other surgical techniques to damage healthy skin that surrounds the lesions. Its precision is especially valuable for recurrent or aggressive skin cancers, and for high-risk lesions (such as those near a facial nerve). It also boasts the highest reported cure rate and lowest recurrence rate for basal and squamous cell cancers.

Mohs surgery is more time consuming for the surgeon (and more expensive) than traditional excision. However, it is considered the gold standard for removing cancerous lesions in cosmetically important areas of the face, such as the nose, eyelids and lips. In fact, in some instances, Mohs' surgery wounds may not even need surgical reconstruction.

When post-Mohs surgical reconstruction is needed, it can be performed immediately following Mohs surgery by a well-qualified and experienced reconstructive plastic surgeon.

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