Baton Rouge Mohs Surgery

Our board certified dermatologists in Baton Rouge specialize in Moh’s Surgery and the treatment of skin cancer.

Overview of Mohs surgery

Mohs surgery, also called Mohs micrographic surgery, is a precise and highly effective outpatient surgical procedure used to treat skin cancer. During Mohs surgery, a Mohs micrographic surgeon will progressively remove, examine, and evaluate thin layers of tissue to ensure that no cancer remains while you wait comfortably in the office. Due to this precise approach, Mohs surgeons are able to ensure the cancer has been removed by examining the tissue in the office lab and repeat this procedure until 100% of the skin cancer is removed. Removing cancerous tissue, preserving healthy tissue, and continuing this technique until only cancer-free tissue remains gives you the highest cure rate and minimizes scarring as compared to all other skin cancer treatments.

Compared to standard surgery (i.e. wide local excision), which removes both cancerous and healthy tissue at the same time, Mohs surgery makes it possible for surgeons to remove malignant tissue while doing minimal damage to the surrounding healthy tissue. Because of its precision and effectiveness, Mohs surgery is known to have a more than 95%, and at times as high as 99% success rate for treating skin cancer. It is classified as an outpatient procedure.

Our Baton Rouge Mohs micrographic surgeons use Mohs surgery to treat basal cell carcinoma and squamous cell carcinoma, the two most common types of skin cancer, and have also found it to be an effective treatment for some kinds of melanoma and less common skin cancers. This type of surgery is most often used to treat cancers that are large, aggressive or recurring; have poorly defined borders; or are located in anatomically, functionally or cosmetically sensitive areas—like the face, ears, feet and genitals—where it’s especially important to the patient that the surgeon preserve as much of the healthy tissue as possible.

Mohs micrographic surgery was developed in the 1930s by general surgeon Frederic E. Mohs, MD (1910-2002). Decades later, it is still the most advanced, effective and precise skin cancer treatment on the market, performed only by dermatological surgeons who have received specialized, comprehensive training in Mohs micrographic surgery.

Risks associated with Mohs surgery

As with any surgical procedure, Mohs carries with it a degree of risk. The most common complications include:

• Bleeding – bleeding is usually well controlled in the office, and occurs more frequently in patients who take blood-thinning medications.
• Infection – infection is possible in any surgery, and typically occurs in less than 5% of cases
• Pain around the surgical area, typically for a few days following surgery.
• Scarring – all treatments result in scarring, and is typically smaller with Mohs than with other procedures

Less common complications include:

• Itching
• Numbness or weakness around the surgical area, which may be temporary or permanent

How to prepare for Mohs surgery

• Consider your medications – Before your surgery, discuss any medications and/or supplements you may be taking with your dermatologist. Some blood-thinning medications and certain supplements, like fish oil, may increase your risk of bleeding after surgery. Unless recommended by your surgeon or physician, continue taking any prescription medications as previously instructed.
• Block off the day – While for most people the entire procedure takes only a few hours, it’s not always possible to predict accurately how long Mohs surgery will take. For this reason, it’s wise to clear your schedule for the entire day of this outpatient surgery.
• Dress in layers – Unless the location of the tumor requires that you to dress in a surgical gown, you will likely wear your own clothes during the Mohs procedure. Since it can sometimes be chilly in the operating room, it may be worth it to dress in layers.
• Expect to have down time – Expect to wait about an hour while your surgeon analyzes the tissue removed during Mohs surgery, and to repeat this process if further layers are necessary to clear the cancer. To pass the time, it may help to bring a book, snack or something to work on. Wifi is available for all patients.

What to expect during Mohs surgery

Because it can be difficult to determine the full scope of the skin tumor with only a surface examination, your dermatologist may advise you to block off the entire day for your Mohs surgery. However, compared to other skin cancer removal surgeries, the procedure is relatively less invasive and requires only a local anesthetic. Typically, the entire procedure takes less than four hours to complete for small to medium tumors, and may take longer for larger or more extensive cancers. Here’s what to expect:

Before the surgery begins, your Mohs micrographic surgeon and surgery team will prep you for surgery, numbing the surgical site with a local anesthetic.

Once the local anesthetic has taken effect, your surgeon will remove the visible part of the skin tumor, along with a thin layer of additional tissue. Your surgeon will take special care to preserve as much healthy tissue as possible, a technique that minimizes scarring.

Your surgeon will then mark the removed cancerous tissue specimen and the treated area, creating a precise map of the cancerous site.

Once both the specimen and treated areas are marked and mapped, your surgeon will step away to examine and process the cancerous specimen. This part of the procedure may take about an hour to complete, so it can be helpful to have some sort of activity or reading material to help you pass the time.

While you wait, your surgeon will be in an on-site laboratory, processing the cancerous specimen, cutting it into segments and examining each section under a microscope. Your surgeon will then identify and map out any residual cancer that matches up with the treatment area.

After any residual tumor has been pinpointed, your surgeon will return and remove another thin layer of skin, cutting away the cancerous area while taking care to preserve as much healthy skin as possible. Your Mohs surgeon will repeat this procedure of removing, mapping, examining and evaluating until 100% of the skin cancer is eradicated.

Once the Mohs surgery is successfully completed, your Mohs micrographic surgeon will use cosmetic reconstructive surgery to repair the surgical site. There are five primary ways to repair a Mohs surgery wound, including:

• Allowing it to heal naturally
• Closing the skin in a line
• Moving and stretching skin from an adjacent area to cover the wound
• Using skin from another area of your body as a skin graft
• Utilizing a combination of the above techniques

At Sanova Dermatology in Baton Rouge, our experienced cosmetic dermatologic surgeons will select the method that will give you the best, most aesthetically pleasing result.

Expected results from Mohs surgery

With a cure rate higher than 95% for most tumors, and as high as 99% for the most common form of skin cancer, Mohs surgery is the most advanced and effective skin cancer removal treatment available today, even for skin cancers that have previously been treated by another method. In addition to its efficacy, Mohs surgery also offers the added benefit of relative immediacy—you’ll leave your appointment knowing your results, and in most cases your skin cancer will have been removed completely. Add to that the focused precision of Sanova Dermatology’s cosmetic reconstructive surgery, and you can expect to leave your appointment not only cancer free, but also with the very best cosmetic results. Mohs surgery results in the highest cure rate with the least amount of scarring.

Follow up after Mohs surgery

Upon the successful completion of Mohs surgery, the likelihood of your skin cancer returning to the site is less than with any other technique. Although the risk of recurrence is dependent upon your tumor type, and whether you’ve had other previous treatments, it is usually less than 5% and often as low as 1%. Though the risk of recurrence is low, it will be important for you to schedule regular follow-up exams with your dermatologist as a form of prevention and early detection against future cancers. Once a person has been diagnosed with skin cancer, they are more likely to develop skin cancer again. It’s been reported that as many as 50% of all people diagnosed with skin cancer will develop another occurrence of skin cancer within five years. For most people, regular yearly or twice-a-year follow-up visits with your dermatologist will ensure that you stay ahead of even the most aggressive forms of skin cancer.

Contact Sanova Dermatology

For more information on Mohs micrographic surgery, or to schedule a consultation with one of our experienced dermatologists, please contact Sanova Dermatology of Baton Rouge today. Need a location closer to you? See our other Louisiana locations.