Mohs surgery, named after Frederic Mohs, the general surgeon who developed it, is a microscopically controlled surgery. By removing thin layers of skin and checking each layer for cancerous cells, the surgeon is able to remove the least possible amount of skin tissue. When there are no longer any cancerous cells, the surgery is complete. Used to treat skin cancer, most often primary basal cell carcinoma (the most common type of skin cancer), it is particularly used for highly visible and sensitive areas of the body, such as the face, hands, feet, etc. Depending on the amount of skin removed, reconstructive surgery performed by a plastic surgeon may be required following the procedure.
Q: What part does the plastic surgeon play in my Mohs surgery?
The plastic surgeon’s role is to provide the patient with an aesthetically pleasing outcome after the Mohs surgery. A dermatologist will remove the cancerous tissue and close the wound. This is all that is required when the wound is small and shallow. However, a deeper wound requires specialized techniques to close, and in some cases, the tissue beneath the skin must be reconstructed.
Q: My dermatologist says she will cut out all of the cancerous cells, but I am afraid this will leave me with a giant dent on my nose. Is that true?
Every outcome depends on a unique set of variables. A qualified reconstructive surgeon will minimize any deformity and reduce the scar burden as much as possible.
Q: Will my nose look the same as it did before I had the cancer removed?
The goal of reconstructive surgeon is to restore your nose as closely as possible.
Q: Will I have permanent scars?
Yes, but a good surgeon will minimize them as much as possible. Though the scars will be permanent, they will diminish in 2-3 years.
Q: Is the reconstructive surgery performed on the same day as the Mohs surgery?
Yes, it is usually performed within 24 hours.
Q: What happens after the surgery? How long does it take to heal?
After the surgery, you’ll go home. There is usually minimal pain, although you may experience swelling and bruising. After five to seven days, the sutures will be removed. Healing depends on the individual, but most people feel they look like their normal selves within two to eight weeks.
Q: Is there anything I can do to improve the look of the incision afterward?
Many patients benefit from lasers and fillers, which can help smooth the skin and reduce discoloration. In cases resulting in highly noticeable scars, secondary scar revision surgery may be desired.
Q: Can the skin cancer come back?
Yes. A patient with skin cancer has a higher chance of developing another one, so follow-up visits to your referring dermatologist are very important.
Q: Can I prevent future cancers?
You should wear appropriate sun protection, as recommended by your dermatologist. Avoid going outside during the hours of peak sunlight and cover yourself to minimize exposure. Keeping a close watch on your skin and reacting quickly will help ensure the best outcome should a new cancer develop.