Mohs micrographic surgery is the most effective and state-of-the-art procedure for skin cancer today, which offers the highest potential for recovery – even if the skin cancer has been previously treated by another method and recurred.
Dr. Kristen Richards, our Founder and CEO, is one of very few Fellowship-trained Mohs micrographic surgeons here in San Diego. Our La Jolla practice located conveniently close to Del Mar and surrounding San Diego areas, is one of only a few to offer this highly advanced procedure by a Fellowship-trained surgeon.
Mohs is a specialized micrographic surgical technique used to remove cancerous lesions in the skin. Allowing physicians to remove skin cancer more effectively, while causing less damage to surrounding healthy tissue than any other method, Mohs is particularly ideal for the removal of large tumors, such as those with irregular edges, and skin cancer that appears on the face or near delicate parts of the body.
Mohs Micrographic Surgery is primarily used to treat basal and squamous cell carcinomas, but can be used to treat less common tumors including melanoma.
Mohs Surgery is appropriate when:
- The cancer is in an area where it is important to preserve healthy tissue for maximum functional and cosmetic result, such as eyelids, nose, ears, lips, fingers, toes, genitals;
- The cancer was treated previously and recurred;
- Scar tissue exists in the area of the cancer;
- The cancer is large;
- The edges of the cancer cannot be clearly defined;
- The cancer is growing rapidly or uncontrollably.
The first step in the Mohs micrographic surgery process is the removal of the visible portion of the tumor. This is accomplished through surgical excision or curettage (scraping). Once this step is complete, a thin sample of tissue is taken from the area of which the tumor was removed then carefully examined with a powerful microscope to screen for the presence of any additional cancerous tissue. If such tissue is found, its precise location is determined and another small section of tissue is removed from this area. This sample is examined under the microscope as well, and the process is continued until it is determined that no additional cancerous tissue remains. By using this systematic method to seek out the roots of a tumor, Mohs surgeons have a 97 to 99 percent chance of successfully removing the entire cancer, leaving the surrounding tissue largely unharmed. Mohs surgery has been especially helpful for removing cancerous tumors when other forms of treatment have been unsuccessful.
The final stage of the Mohs surgical procedure is the closing of the wound left by the excision. The specific method used to complete this step will depend on the size, shape, and location of the incision. Small, shallow openings may be dressed and left to heal naturally, while larger wounds may need to be closed with stitches or repaired with a skin graft. The decision as to which of these methods will be most effective is generally made once the cancer has been removed and the extent of the excision is known.
Dr. Kristen Richards, our Founder and CEO, is one of very few Fellowship-trained Mohs micrographic surgeons here in San Diego. The American College of Mohs Micrographic Surgery and Cutaneous Oncology (www.mohscollege.org) is the official organization responsible for training Mohs surgeons and maintaining a high standard of care in the specialty of Mohs surgery. To become a member of this organization and to be known as a Mohs surgeon, a special one to two-year fellowship, following a dermatology residency, is required. Only a limited number of dermatologists are trained each year to be Mohs surgeons, in order to maintain the highest level of competence in the specialty.
If your doctor has referred you to Torrey Pines Dermatology to have Mohs micrographic surgery at our La Jolla practice, you will be scheduled for a preoperative consultation. This visit allows Dr. Kristen Richards to examine your skin cancer, obtain your medical history, and determine whether the technique of Mohs micrographic surgery is the most appropriate treatment for you. It also gives you the opportunity to meet Dr. Kristen Richards and her staff and learn about the procedure.