top of page
CertMark-18619m.png

Mohs surgery is used in the treatment of skin cancers. Dr. Stein has extensive experience in performing Mohs Surgery. 

Dr. Stein at Stein Dermatology performing Mohs Surgery. Stein Dermatology is located in La Messa San Diego.

Mohs surgery and staged excisions consists of taking small layers of skin and checking with a microscope if the whole tumor is removed. It allows best preservation of the surrounding skin and ensures that all the tumor is removed. May take longer time since all the processing of the specimens is made immediately after removing the tumor. Mohs /Staged Excisions are performed on the face, neck and hands, in sensitive areas where skin preservation is very important. Simple excision consists of excising a skin cancer with margins. Specimens are checked by pathology and a follow-up visit is scheduled in 2 weeks at which time results are available to confirm that all the skin cancer was removed.

Frequently asked questions by Mohs patients:

 

Is Mohs surgery/staged excision the best treatment option for all skin cancers?

It gives the best cure rate (up to 99%), for certain lesions where this approach is recommended, but some insurances may not cover Mohs for all skin cancers. If you have any type of suspicious skin lesion you should seek evaluation by our dermatologists. If skin cancer is suspected, the doctor may recommend and perform a biopsy. Mohs surgery may be recommended based on the type and location of the skin cancer, as well as other factors.  

Will Mohs staged excision surgery be covered by my insurance plan? 

Mohs surgery, if recommended by the dermatologist, is covered by most insurance plans, including Medicare. Please ask your employee benefits administrator and/or our billing specialist to determine if there are any estimated out-of-pocket expenses.

Will skin surgery and Mohs surgery leave a scar?

All surgical procedures have the potential for certain degree of visible scarring. The appearance of a post-Mohs surgical scar will depend on several factors, including size and location of the final defect, individual skin characteristics, and the reconstruction options available. You should keep in mind, however, that the tissue-sparing nature of the Mohs technique may result in a smaller, less noticeable scar than other skin cancer removal methods. The Mohs surgeon also may be able to incorporate suture lines into the patient's natural skin lines and folds. Most scars improve in appearance naturally over time, and future scar revision techniques may be employed if necessary.

My skin cancer is in a very noticeable facial area and I am concerned about my appearance following Mohs surgery. Should I have the skin cancer removal performed by a plastic surgeon?

If it is your preference to have a plastic surgeon perfom the reconstruction after the removal of the skin cancer, you may discuss this ahead of time with our dermatologist/Mohs surgeon during your preoperative visit. Our office will be able to help coordinate this type of shared treatment approach. If the skin cancer involvement is extensive or in difficult areas, our Mohs surgeon will recommend and collaborate with other subspecialties.

What are advantages of the Mohs/staged excision Surgery (provided that this is recommended by the Dermatologist)?

Some skin cancers can be deceptively large – far more extensive under the skin than they appear to be from the surface. These cancers may have “roots” in the skin, or along blood vessels, nerves, or cartilage. Skin cancers that have recurred following previous treatment may send out extensions deep under the scar tissue that has formed at the site. Mohs surgery is specifically designed to remove these cancers by tracking and removing these cancerous “roots.” For this reason, prior to Mohs surgery it is impossible to predict precisely how much skin will have to be removed. The final surgical defect could be only slightly larger than the initial skin cancer, but occasionally the removal of the deep “roots” of a skin cancer results in a sizeable defect. The patient should bear in mind, however, that Mohs surgery removes only the cancerous tissue, while the normal tissue is spared. Therefore, Mohs surgery results in a reduced scar formation, potentially less than than simple excision, give the more conservative tissue removal employed.

Dr. Stein visualizing histopathology slides over the microscope. Mohs surgery is performed on-sit at Stein Dermatology in San Diego.

STEPS  
 of Mohs Surgery

CAM00102ccc.jpg

1

Before scheduling Mohs surgery, we conduct an initial visit in order to evaluate the specifics of your surgery and your general condition.

We recommend that you read the linked Pre and Post Surgical instructions page.

2

At the commencement of Mohs Surgery, Dr. Stein will carefully map the area and delineate the perimeter of the skin cancer.

Anesthesia will be used to enhance comfort and effectiveness of the procedure.

3

The skin cancer will removed in stages, according the the stages of Mohs technique, with care exerted to conserve the normal surrounding tissues.

A Mohs Map is made that locates and tracks the edges and structural details of the cancer and surrounding areas.

4

At the time when the total removal of cancerous tissue was confirmed under the microscope, Dr. Stein will come to discuss with you the surgical reconstruction of the area. He will draw design options and formulate the preferred methods(s) detailing the pros and cons of each modality.

5

The surgical closure commonly employs the use of surgical sutures. They will need to be removed at the time when the degree of would healing permits.

Please refer also to the downloadable material linked which contains further post-surgical general instructions.

6

At Stein Dermatology and Skin Surgery we strive to achieve excellent results. Our Team consisting of Mohs surgeon, Dedicated Nurser, Surgical Assistants and Technicians work together investing talent and passion to optimize your outcome. We pay great attention and and care to maximize both cosmetic and functional results.

#20140102_143906c.jpg
#20140102_145610cc.jpg
20150926_104044c.jpg
#20140103_110641c copy.jpg
#20140122_115909c.jpg
CAM00113c.jpg
bottom of page