Introduction to Mohs Micrographic Surgery
Mohs micrographic surgery is a specialized surgical technique used to treat skin cancer with superior effectiveness and tissue preservation. Named after Dr. Frederic Mohs who developed the technique in 1938, this procedure combines surgical removal with real-time microscopic examination to ensure complete removal of malignant tissue while conserving healthy skin.
How Mohs Surgery Works
Unlike standard surgical excision where tissue is removed and sent to a laboratory, Mohs surgery operates differently. The surgeon removes thin layers of tissue horizontally and examines them immediately under a microscope. This allows the surgical team to map the exact location and extent of cancer cells, enabling precise removal of diseased tissue while preserving as much healthy skin as possible.
Key Characteristics
- Highest cure rate among skin cancer treatments, exceeding 99% for most common skin cancers
- Removal of tissue occurs in thin horizontal layers rather than vertical sections
- Real-time microscopic examination during the procedure
- Systematic mapping of cancer margins
- Immediate reconstruction after cancer removal
Indications for Mohs Surgery
Mohs micrographic surgery is particularly valuable for skin cancers in cosmetically sensitive areas, recurrent cancers, cancers with ill-defined borders, and high-risk histological subtypes. The technique is approved for basal cell carcinoma, squamous cell carcinoma, and selected cases of melanoma and other malignancies.
Advantages Over Conventional Excision
The primary advantage of Mohs surgery is the dramatic improvement in cure rates combined with superior tissue conservation. Because the surgeon can verify complete removal in real-time, there is minimal need for re-excision. This translates to smaller surgical defects and superior functional and aesthetic outcomes, particularly important when treating cancers near critical structures like the eyelids, nose, or lips.