Approximately 1 in 5 Americans will develop skin cancer in their lifetime, and unfortunately, the incidence is rising. The most common forms of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma. When these skin cancers are detected early, there is a very high cure rate with proper treatment. Mohs surgery is the gold standard in skin cancer treatment. This procedure offers the lowest risk of recurrence for most skin cancers because 100% of the surgical margins are examined on-site by the surgeon at the time of the procedure.

The surgeon is able to provide the highest level of care to her patients by completely removing skin cancer in a single surgical setting and following this immediately with the reconstruction. Since real-time microscopic examination is utilized, the areas involved with cancer can be pinpointed and traced to their deep and peripheral roots, and then only those areas involved are selectively excised. This results in removal of as little normal tissue as possible, which has important implications for the complexity of reconstruction required and the duration of healing. Mohs surgery is therefore safe and convenient, and psychologically ideal for patients to know they are leaving the office skin cancer-free. This procedure is also the most cost-effective approach, reducing the likelihood of recurrence and the resulting treatments that this would incur. Additionally, the fees associated with multiple office visits and pathology readings, and in-hospital treatment, are avoided.

Yes, however, Mohs Surgery helps to minimize scarring as much as possible. The functional and cosmetic outcomes are maximized because the surgeon tries to remove only the tissue involved by cancer cells and preserve all of the normal tissue possible. We make every effort to obtain an optimal cosmetic result for our patients.

If you are referred, instructed or request a pre-operative visit, you’ll speak with Dr. Findley and have all your questions answered. This also gives her the opportunity to examine your skin cancer and surrounding skin, review your pathology report with you, and discuss any pertinent history. She can then determine the best form of treatment and customize her approach, as well as explain the expected course of healing. Our team will work with you to schedule the surgery date. If we do not have a pathology report, we may perform a biopsy at the initial visit. If Dr. Findley suspects a growth is skin cancer, the first step is obtaining an accurate diagnosis through examination, followed by a biopsy which is then sent for pathology. Once this report is received, she can then determine the best modality of treatment.

All patients will be photographed before treatments as well as immediately after surgery and again after healing. These photographs become a part of your medical record.

Try to come to the procedure well-rested. If you are taking any medications, take them as usual unless we direct otherwise. If you take aspirin or aspirin-containing products or blood thinners, do NOT discontinue your blood thinners without consulting with Dr. Findley or your other managing physicians first. No fasting is required the day or night before. East breakfast and bring a book or magazine with you on the day of surgery. When you arrive, you will be brought back into a surgical room where the surgeon will talk through a detailed consent. The biopsied area will be identified and confirmed by you and the surgeon. The area will be numbed and then the tumor will be removed. Again, several advantages of this technique are that we can minimize how much normal tissue is removed and we can test the area under the microscope the same day. If cancer cells are identified under the microscope, the surgeon will return to remove additional tissue (“take a layer”), and this process will be repeated until the area is cleared of the tumor. Each step of the surgical procedure can take anywhere from 30 minutes to a few hours (the latter may be applicable to Mohs for melanoma).

Depending on the type of skin cancer being treated, processing the tissue can sometimes require special staining, so the total length of the procedure can be anywhere from 2-5 hours or longer. Much of this time will be spent in the exam or waiting room. Several surgical stages and microscopic examinations may be required. Please visit our Pre/Post Surgery Instructions for a detailed overview of what to expect on the date of your procedure.