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 the Mohs surgery procedure, leaving very little in the way of a Mohs surgery scar. Make your appointment today in our state-of-the-art Dermatology NYC clinic with a leading dermatologist and Mohs surgeon located in Midtown, New York, NY & Upper East Side, New York, NY. Dr. Bard is among the best dermatologists NYC 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, New York, NY & Upper East Side, New York, NY
What Is Mohs Surgery?
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. Though it’s been around since the 1930s, when Dr. Frederick Mohs first introduced the technique, Mohs surgeons only began to embrace the procedure in the 1990s.
Your Manhattan dermatologist agrees that the Mohs surgery procedure 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 Mohs 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 and is increasingly used to treat melanoma. Mohs micrographic surgery has the highest cure rates, saves the maximal amount of normal tissue.
Mohs Surgery Explained
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.
Mohs surgery eliminates the guesswork in treating skin cancer. Mohs micrographic surgery 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 Has a Low Recurrence Rate
Multiple observational studies have consistently demonstrated that Mohs micrographic surgery 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 Recommended?
Mohs micrographic surgery is recommended 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.
Mohs procedure treatment 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)
Mohs 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, the Mohs procedure 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 skin doctor recommended Mohs, you can take comfort in knowing that it has a very high cure rate. Your Mohs surgeon will only remove the minimal amount of skin needed to treat the cancer.
The Mohs Surgery Procedure in our New York Facility
After numbing the area with local anesthesia, your Mohs surgeon or your laser Mohs dermatology specialist 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 surgeon Dr Bard can scrape away one layer at a time until all the malignant cells are removed. The procedure may take hours in New York Mohs surgeon’s office, but the targeted lesion will be cancer-free by the time you leave. That’s the value of the Mohs surgery procedure Dr. Bard perform in our dermatology center located in Midtown, New York, NY & Upper East Side, New York, NY.
Dr. Susan Bard is a leading Mohs surgeon and Dermatologist with an 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
Modifications of Mohs Micrographic Surgery for Specific Melanomas
Slow Mohs surgery that is performed by Mohs surgeon 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 Mohs surgeons office, the slow Mohs 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 Mohs surgery is ideal for older patients, who most likely suffer from lentigo maligna melanoma anyway.
Prognosis of Mohs Dermatology
Mohs surgery melanoma discoveries have led to a 98 percent recovery rate when performed in the early stages of the cancer. While Mohs 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 Mohs dermatology procedure is suitable for you.
Having a Manhattan dermatologist highly trained in Mohs micrographic surgery 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 Mohs surgery scar. The Mohs surgery procedure removes the least amount of skin and leaves the smallest scar, as compared to other surgical excision options.
Side Effects and Mohs Surgery Recovery
Typically, you have little if any pain following a Mohs 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 immediately if you experience chills, fever, swelling, increasing redness or severe pain following a Mohs surgery procedure.
Minor complications following a Mohs procedure that disappear in 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 adhesive tape was used to block off an area of your skin
- Numbness, which may last for months — if 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 Mohs micrographic surgery due to their increased size and need for repair with methods other than linear closures.
Other Skin Cancer Treatments in NYC
If you’re in poor health or can’t tolerate procedures that rely on local anesthesia, the Mohs surgery may not be right for you.
Other skin cancer treatment options 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 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.
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.
Do you have any questions about Mohs Surgery? Would like to schedule an appointment with an internationally recognized, best Mohs dermatologist Dr. Susan Bard of Manhattan Dermatology? Please contact our Midtown New York, NY or Upper East Side New York, NY dermatology clinic for a consultation with New York laser dermatologist and a leading Mohs surgeon in NYC.
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