Mohs micrographic surgery is utilized to treat skin cancers located on cosmetically sensitive areas of the body, particularly the face. Mohs is also used for high-risk, complex and recurrent cancers. When compared to any other modality available for skin cancer removal, Mohs micrographic surgery offers the highest cure rate.
Mohs is the only skin cancer removal method that evaluates 100% of the surgical margin. Dr. Khorasani uses a microscope to trace cancer down to its roots. This technique allows Dr. Khorasani to identify and remove the entire cancer and leave behind only normal, healthy tissue. This is an advanced surgical procedure where Dr. Khorasani functions as the oncologic surgeon, the pathologist, and the reconstructive surgeon.
Most patients do not have pain. If a patient is uncomfortable, we recommend taking 2 Tylenol® every 4 to 6 hours.
Bleeding rarely occurs after surgery. If bleeding occurs, it is easily stopped by firm pressure and in-office electrocautery.
Major complications are rarely seen after Mohs surgery. However, swelling and bruising are very common. Allergic reactions to adhesive tape covering the wound are also very common. They usually occur after day 2 and are controlled with topical steroid creams. Infections are rare. Should one occur, it is most often after day 5 and is controlled with antibiotics.
It is extremely common to have bruised and VERY swollen eyelids after Mohs surgery. This is often the case when one operates on the forehead, scalp, and nose. Bruising usually lasts between 7-12 days. Arnica tablets may help with the bruising. You should sleep elevated with multiple pillows so that your head is above the level of your heart. You should ice the treated area for the first 24 hours with a bag of frozen peas.
Avoid physically strenuous activity, heavy lifting or exercising for 2 weeks after surgery.
You will initially have strips on the wounds; you do not need to apply anything on top of them. You may shower with the strips and should keep the area clean. My staff and I will discuss wound care instructions with you in depth depending on your procedure. You will also receive written instructions prior to leaving.
Healing time varies and depends on the patient’s medical history. Healing time also depends on the method used to close the defect:
If you need to have skin cancer removed, a general rule of thumb is that the incision or scar will be at least twice the length of the cancer lesion. This is because the lesion is only the outward sign of cancer, and Dr. Khorasani needs to remove a larger safety margin below your skin’s surface.
The good news is that the face is very vascular and, with time, the body heals itself. No surgeon can promise a scarless surgery, but Dr. Khorasani makes every effort to hide the scars in ways that are significantly less noticeable. For example, he might use a PlasmaBlade™, which causes significantly lower collateral damage compared to traditional electrocautery. The reduction in collateral damage allows your body to heal faster and produces less scar tissue.
The care you take after surgery will go a long way toward minimizing scarring. Here are some steps you can take:
Once the site is healed, approximately two weeks later, it is essential to apply sunscreen to protect this new, fragile skin. Sunscreen should be reapplied every 4 hours, and much more often if sweating or exercising outdoors.
Generally, scars will take their final form after 6 months. Ultimately, the treatment will depend on the type of scar you would like corrected. Dr. Khorasani has a host of options available customizable to your needs.
*Individual results may vary