Mohs surgery is ideal if skin cancer is discovered in a spot that is cosmetically important to you, such as on your face. Basal and squamous cell carcinomas respond well to this type of skin treatment surgery, with minimal scarring. Make your appointment today in our Dermatology NYC clinic with a leading New York City dermatologist Dr. Bard. She is among the best dermatologists and one of the top Mohs surgeons in the country. She is an internationally recognized book author and contributor to multiple industry top dermatology citations.
Our Manhattan dermatology and cosmetic surgery centers are located in Midtown, Manhattan & Upper East Side, New York
- What Is Mohs micrographic surgery?
- Mohs surgery explained
- When is this procedure recommended?
- The Mohs micrographic surgery procedure in our New York facility
- Modifications for specific melanomas
- Prognosis of skin cancer treatment
- Side effects and recovery after surgery
- Other skin cancer treatments in our New York center
- How long does a surgery take?
- What does MMS stand for?
- How much does it cost?
- How long does a Mohs Surgery take to heal?
- How to prepare for the procedure?
- Who performs Mohs surgery?
- What does recovery after Mohs surgery entail?
- Is Mohs surgery painful?
What Is Mohs Surgery?
A board-certified dermatologist should evaluate all symptoms and signs for an accurate diagnosis and treatment plan to be formed As researchers continue to grapple with finding new and better ways to treat cancer, one treatment stands out as one of the most promising tools to fight skin cancer: Mohs micrographic surgery (MMS). Though it’s been around since the 1930s, when Dr. Frederick Mohs first introduced the technique, surgeons only began to embrace this procedure in the 1990s. Your Manhattan dermatologist agrees that Mohs skin cancer surgery is an exceptional technique that can lead to quick and thorough cancer diagnoses and treatments.
Dr. Bard is among the best-rated Mohs surgeons in the country. She is fully trained and extensively experienced at using the in-office skin cancer treatment. Your local expert in skin cancer surgery is prepared to perform this procedure.
Mohs micrographic surgery (MMS) has become the standard of care for the treatment of high-risk nonmelanoma skin cancers. It is increasingly used to treat melanoma. This type of skin cancer treatment has the highest cure rates, saves the maximal amount of normal tissue.
What Is the Essence of a Mohs Surgery?
Prior to the development of modern Mohs surgical procedure, you had to wait to hear back from a laboratory to find out the results from a skin biopsy. If your dermatologist removed a piece of an unknown skin lesion, the lab would determine if the skin sample was benign (non-cancerous) or malignant (cancerous). You also may have had to return for multiple excisions before your dermatologist could be sure that all the cancerous skin cells were removed. This type of surgery eliminates the guesswork in treating skin cancer. MMS allows your New York Mohs surgeon or your local dermatologist to scrape away tiny slivers of your suspicious growth and, using a simple microscope in the office, determine whether the slice of skin contains residual malignant cancer cells.
Mohs Micrographic Surgery (MMS) Has a Low Recurrence Rate. Multiple observational studies have consistently demonstrated that this procedure has a low recurrence rate often much lower than surgical excision. According to a study published on pubmed “Mohs micrographic surgery (MMS) in the treatment for cutaneous basal cell carcinoma (BCC)”, out of 3370 patients enrolled (1594 female and 1776 male patients, 56% primary tumors and 44% previously recurrent tumors). Recurrence at 5 years was diagnosed in 1.4% of primary and in 4% of recurrent tumors.
When Is Mohs Surgery Necessary?
Mohs surgery specialists recommend this type of procedure to patients with common skin cancers such as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). It is also used as a skin cancer treatment for certain kinds of melanoma and other more unusual skin conditions. The surgery for skin cancer is especially useful for patients with tumors that:
- Have a high risk of recurrence
- Are large or aggressive
- Located in areas with little tissue beneath, such as eyes, nose, mouth, ears, scalp, hands, feet, and genitals)
- Don’t have clearly defined borders
An indications for Mohs micrographic surgery (MMS) either alone, or in as part of an overall treatment approach include the following:
- BCC (Basal Cell Carcinoma)
- NMSC (Nonmelanoma Skin Cancer)
- SCC (Squamous Cell Carcinoma)
- Basal cell nevus syndrome
- Cutaneous tumors:
- Keratoacanthoma (KA)
- Dermatofibrosarcoma protuberans (DFSP)
- Microcystic adnexal carcinoma (MAC)
- Atypical fibroxanthoma (AFX)
- Other rare tumors (Angiosarcoma, Sebaceous gland carcinoma, Extramammary Paget’s disease, Malignant fibrous histiocytoma, Leiomyosarcoma, Adenocystic carcinoma, Apocrine or eccrine carcinoma, Merkel cell carcinoma)
Our doctors are the best-in-class board-certified physicians. Please call for an appointment. Skin cancer surgery is also used to treat certain rare conditions such as DFSP, extramammary Paget’s disease, and Merkel cell carcinoma. Regardless of the type of skin condition you have, Mohs skin surgery is only recommended for certain patients. You must only have one or several skin cancers that are very close together.
Having any type of skin surgery can be intimidating. However, if your nearby dermatologist or surgeon specialist Dr. Bard recommended Mohs micrographic surgery, you can take comfort in knowing that it has a very high cure rate. Your dermatologist will only remove the minimal amount of skin needed to treat cancer.
Excision for MMS is performed in several steps. First, a thin layer of cancerous tissue is removed, then the second layer of tissues is removed and viewed under a microscope for the purpose of checking for cancer cells. More layers are removed one at a time until the tissues viewed under a microscope depicts no remaining cancerous cells. Conventional excision is considered standard treatment though randomized trials with long-term follow-up are rare. These excisions may be regarded as the optimal treatment of basal cell carcinomas. During conventional excision, a larger amount of tissue is taken at once resulting in more scars than you would have with Mohs micrographic surgery. Moreover, in traditional excision, only 1 percent of the edges are examined under a microscope.
How Is Mohs Surgery Performed?
After numbing the area with local anesthesia, your doctor, or your laser and Mohs dermatology specialist Dr. Bard removes a thin layer of skin from the growth and from surrounding margins. Viewing it under a microscope, it’s possible to discern if the margins are completely clear of cancer. If so, then that’s the end of the treatment. If, however, some cancer cells are still present in the surrounding skin, Mohs surgery specialist Dr. Bard can scrape away one layer at a time until all the malignant cells are removed. The procedure may take hours but the targeted lesion will be cancer-free by the time you leave. Dr. Bard is accepting patients for Mohs micrographic surgery in our Mohs surgery and dermatology center located in Midtown, Manhattan & Upper East Side, New York. Dr. Susan Bard is a leading dermatologist with additional training in the field of MMS, skin cancer management, and dermatological surgery. This procedure is done in stages in one visit, while the patient waits.
- Examination and preparation
- Top layer removal
- Lab analysis
- Microscopic examination
- Second layer removal
- Wound repair
- Finishing up
What Are the Modifications of Mohs Micrographic Surgery for Specific Melanomas?
Slow Mohs surgery that is performed by the leading dermatologist Dr. Bard in our New York laser clinic is a slightly modified version of the breakthrough Mohs Micrographic Surgery procedure. It’s primarily used to treat lentigo maligna melanoma, a form of the deadly skin cancer that appears in the epidermis and accounts for about four percent of all melanoma cases. Lentigo maligna melanoma often presents on your neck or face, particularly on your cheeks or nose — the spots where sun damage is most prevalent.
Instead of getting instant results in the office, the slow MMS surgery, as the name suggests, requires more time. Layers of skin are rushed off to a pathologist for overnight results. The margin-controlled excisions are taken in stages and cosmetic repair is reserved until the final results are in. Slow MMS surgery is ideal for older patients, who most likely suffer from lentigo maligna melanoma anyway.
What Is the Prognosis of Mohs Procedure?
Mohs surgery melanoma discoveries have led to a 98 percent recovery rate when performed in the early stages of cancer. While Mohs skin surgery is not the only treatment available for skin cancer, nor is it always the most judicious, it is ideal when the cancer is in a place that may drastically affect your appearance.
Call to schedule an appointment with the leading New York City Mohs surgeon Dr. Bard to find out if this laser dermatology procedure is suitable for you. Having a Manhattan dermatologist highly trained in Mohs surgery skin cancer treatment is a boon when you need it. And a cosmetic dermatologist is better able to provide you with the cosmetic follow-up to assure you that you won’t have a noticeable surgery scar after the procedure. This type of skin cancer surgery procedure removes the least amount of skin and leaves the smallest scar, as compared to other surgical excision options.
What Are the Side Effects?
Typically, you have little if any pain following the procedure. Any discomfort can be taken care of with over-the-counter pain relievers. Excessive bleeding is rare too; holding a gauze pad over the affected area for 15 minutes is usually sufficient to tide any blood flow. While complications are rare, call your New York Mohs surgeon, Dr. Bard immediately if you experience chills, fever, swelling, increasing redness, or severe pain following this procedure. Minor complications after Mohs surgery, that disappear over time, include:
- Bruising or swelling that lasts for up to five days, especially if the procedure was performed around your eyes — use ice packs help to minimize swelling for the first two days after surgery
- Red skin surrounding the surgical spot, which is common and does not necessarily indicate the presence of an infection
- Itching around the sore, which is also common, especially around the area where the adhesive tape was used to block off an area of your skin
- Numbness, which may last for months — if the feeling doesn’t return after several months, there is a chance that it will be permanent
According to multiple studies, large tumors are at higher risk for complications following skin cancer surgery due to their increased size and need for repair with methods other than linear closures.
What Are the Other Skin Cancer Treatment Options in NYC?
If you’re in poor health or can’t tolerate procedures that rely on local anesthesia, the MMS may not be right for you. Alternatives to Mohs surgery include:
- Excision. This technique is common for basal cell carcinoma. Your dermatologist cuts out the offending tissue and a small margin of skin surrounding the tumor.
- Radiation. This is a more drastic option, but effective, especially if you can’t tolerate local anesthesia or if the tumor is located in a hard-to-reach area such as the edge of your ear or on your eyelid.
- Cryosurgery. This technique involves freezing the tumor. It’s best for small cancerous growths. Cryosurgery can take a month or more to be completed.
- Topical medication. This technique is often reserved for superficial tumors. You usually perform this at home by applying a medicated cream to the growth every night until it disappears.
How long does Mohs surgery take?
Generally, this type of surgery is performed on an outpatient basis in an operating room that is in close proximity to a laboratory. This allows the doctor to evaluate the tissue once it has been removed. In the vast majority of cases, the procedure takes approximately a few hours. However, since it is relatively complicated to tell how extensive a skin tumor is just by looking at its surface, specialists recommend reserving the whole day for surgery.
What does MMS stand for?
Mohs micrographic surgery was named after the founder of this surgery, Dr. Frederick Mohs. The concept of this type of procedure appeared in the 1930s. Although, in the 1970s several major modifications were made to the procedure allowing it to become the leading treatment for people who suffer from skin cancer.
How much does Mohs surgery cost?
It is not possible to give a definite answer to this question as the total cost of the procedure depends on a wide range of factors. On average, Mohs surgery price in the United States varies between $1,000 to $2,000, excluding the cost of the operating facility, anesthesia, and other related meditations. In addition to that, the size of cancer and the amount of tissue that needs to be removed impact the final cost as well.
How long does it take to heal after Mohs surgery?
Keep in mind that once the surgery is completed, your doctor might prescribe you medications to help prevent infection. Moreover, the surgical area will be covered with a bandage before you leave. The bandage has to be kept on for around 24 to 48 hours and your surgeon will let you know when it can be removed. Depending on the size, it may take between 4 to 6 weeks for the wound to heal completely.
How to prepare for the procedure?
Before the surgery takes place, your surgeon will provide you with recommendations on how to prepare for the procedure. Normally, doctors advise stopping taking certain medications that might affect your chances of bleeding after the surgery. Apart from that, you will get instructed to clear your schedule for the whole day as it is nearly impossible to predict the duration of surgery. Moreover, you will be asked to wear comfortable clothes. Make sure to follow the recommendations of your doctor strictly while preparing for Mohs surgery.
Who performs Mohs surgery?
Mohs surgery is a relatively challenging procedure. Many dermatologists (skin doctors) can perform this surgery since they learn about Mohs surgery in medical training. Some dermatologists have even undergone specialized training for the purpose of learning more about the procedure and becoming more skilled in Mohs surgery. Do not forget to ask your doctor about her/his qualifications as well as experience before deciding on a surgeon.
What does recovery after Mohs surgery entail?
Once the procedure is performed, you will be exhausted and tired. Several days following the treatment it is highly recommended to avoid any strenuous activities, including, but not limited to bending. To help prevent infection after Mohs surgery your doctor might prescribe you antibiotics. During the healing phase, your surgical site will be covered with a bandage. You will also be instructed on the type of wound care to use and when you can remove the bandage.
As part of Mohs surgery recovery, it is recommended to make use of ice packs. If you experience post-surgical discomfort, your specialist will advise you on the type of medication that can help. You should keep in mind that light bleeding and minor discomfort are common side effects of the procedure. However, if you experience heavy bleeding or any other issues that concern you, it is advised to seek immediate medical assistance.
Is Mohs surgery painful?
The procedure is safely performed under local anesthesia. You might experience a certain degree of discomfort when the anesthetic is first administered. Although, this discomfort lasts only seconds. Once the treated area is numb, the procedure is not going to be painful. It is possible to experience soreness around the area you had surgery on. It can be managed with Tylenol. In rare cases, your doctor will prescribe pain medications that are to be taken for 1-2 days following the treatment.
Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult dermatologist NYC about your specific condition. Only a trained, experienced board certified Mohs dermatology doctor or pediatric dermatologist can determine an accurate diagnosis and proper treatment.
You can finally stop searching for “the best Mohs doctors near me” and schedule an appointment with an internationally recognized dermatologist Dr. Susan Bard of Manhattan Dermatology. Do not wait any longer and contact our Midtown Manhattan or Upper East Side New York Mohs surgery and dermatology center for a consultation. Our laser dermatologist and a leading Mohs surgeon in NYC will be delighted to welcome you to our office.
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