Mohs Skin Cancer Surgery and Skin Cancer Reconstruction FAQ
What is Mohs Skin Cancer Surgery?
Often times what you see with a mole or skin cancer is just "the
tip of the iceberg". Cancer cells may have spread deeper under
the skin and away from the superficial mole or bump on your skin.
Mohs surgery, also called Mohs micrographic
surgery, is a precise surgical technique that is used to remove
all parts of cancerous skin tumors, while preserving as much healthy
tissue as possible.
How is Mohs surgery done?
Mohs skin cancer surgery allows for the tissue to be examined through
a microscope at the same time as the operation to ensure that all
of the cancer cells have been removed adequately. The surgical removal
proceeds along a grid pattern with each layer carefully identified
and mapped by the surgeon so that its exact location can be pinpointed
on the wound. If any cancer cells are seen under the microscope,
the surgeon can go back to that exact area and remove more tissue.
In our office, the defect (hole created from removing the cancer)
will be closed and/or reconstructed by Dr Hoenig right away.
How is this different than regular
skin cancer surgery?
The principle behind Mohs surgery is to remove all cancerous cells
while minimizing removal of healthy tissue. Without Mohs,
your doctor will remove the area of suspected cancer, send it to
a lab, and wait a few days to find out if he got it all out. Meanwhile,
you may be walking around with a bandage over the hole. If the pathologist
says that all the cancer is removed, then your doctor will call
you back (or send you to a plastic surgeon) to have the hole closed.
If the pathologist says that there is still cancer visible in the
specimen they received, then you will return to your doctor's office,
have more skin removed, and repeat the process.
Is it really better to have Mohs
Having Mohs skin cancer surgery allows
your doctor to make sure all the cancer cells are removed, minimize
removal of healthy tissue, and close the skin immediately. Minimizing
tissue removal is especially important for eyelids, lips, the nose,
ears, and other facial areas where loss of even a few millimiters
of skin can make a big difference.
Does having Mohs surgery guarantee
that the cancer won't come back?
Using the Mohs microscopic surgery technique all visible cancer
cells are removed. Even so, it is still possible to get a recurrence
of the cancer in the same area but the chances are greatly reduced.
With Mohs skin cancer surgery, there is a 95% cure rate, compared
to 70-80% for the conventional treatments.
Isn't skin cancer surgery done
by a dermatologist?
Not necessarily. Dr Hoenig is not a dermatologist but there is a
lot of crossover between plastic surgery and dermatology. Often
times a plastic surgeon is called in to perform the reconstruction
on facial skin cancer surgery removals to make sure it looks as
good as possible. As an eyelid and facial plastic surgeon, Dr Hoenig's
background is ideal for this kind of sub-specialization.
Are there some types of cancer
removal that cannot be done with Mohs surgery?
Yes. Melanoma, Merkel cell carcinoma, and sebaceous cell cancers
usually are removed with Mohs surgery due to the highly aggressive
and potentially lethal nature of these cancers. These lesions are
removed by taking a large area around the mole and sending it to
a special lab for examination. The hole created by doing so is closed
How long has Dr Hoenig been doing
skin cancer reconstruction surgery?
Dr Hoenig started peforming skin cancer reconstruction surgery in
1999 and has performed over 12,000 skin cancer cases to date.
Will I have a scar?
Any time you cut the skin, you will have a scar. In most cases,
the scar is barely perceptible. You can view photos of Dr Hoenig's
skin cancer reconstructions (see below) to view the results of skin
cancer reconstruction surgery.
Can I see before and after photos of skin cancer
To view before and after
skin cancer reconstruction photos by Dr Hoenig, click here.
Dr Hoenig performs Mohs skin cancer surgery in conjunction
with Dr. Robert Miller in Long Beach, California. Dr Miller is an
experienced dermatologist and Mohs surgeon, who has been working
with Dr Hoenig for the past 9 years. If you are interested in learning
more about Mohs skin cancer surgery and facial reconstructive surgery,
please feel free to contact
us for more information or call the Long Beach office at 562.420.8333.
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