4 Common Questions About Mohs Surgery

It’s commonly accepted that skin cancer continues to climb at alarming rates, despite public awareness campaigns that promote sun protection. It’s already the most common form of cancer by far, and nearly 5 million Americans are treated each year for all skin cancers combined, with an annual cost estimated at $8.1 billion. The increasing number of cases is leading to more questions about treatments, including Mohs micrographic surgery.

More dermatologists are using Mohs surgery to treat skin cancer as the number of cases rises. The Mohs technique is a precise method of removing cancer cells while leaving intact as much healthy tissue as possible. The method’s cure rate can be up to 99%, and it is especially valuable in areas such as the face and hands, where a good cosmetic result is desired. Although this treatment option is growing in popularity, many skin cancer patients aren’t familiar with the procedure when they are first diagnosed. Let’s look at answers to some of the most common questions about Mohs surgery:

Who should perform Mohs surgery?

At a minimum, a surgeon needs to get specialized training to perform the procedure. But it’s important also to find a surgeon who has completed a Mohs surgery fellowship. This is at least a 1-year fellowship that includes training in skin cancer biology, pathology, the Mohs technique, and reconstructive surgery. Only fellowship-trained surgeons can be members of the American College of Mohs Surgery, which has a website where you can search for a nearby Mohs surgeon in your area.


How long does Mohs surgery take?

The Mohs technique is very precise and involves examining thin layers of tissue under a microscope, so the procedure takes more time than some other techniques, which involve simply excising the lesion and a significant amount of healthy tissue surrounding it. In a Mohs procedure, the patient waits while the tissue is examined, and then more tissue is removed and examined if cancerous cells are found in the margins. In some cases, this takes just a couple of hours, and in others it may take several hours.


How much does Mohs surgery cost?

The economics of Mohs surgery must be looked at in the context of its success rate. Because of the technique’s effectiveness, most patients require only a single surgery. It’s important to remember also that in the majority of cases, the Mohs surgeon repairs the wound on the same day. That’s not necessarily true for other methods, which may require more surgeries to remove more cancer cells or to reconstruct a surgical defect.

“Each of these additional surgeries and pathology readings require separate fees,” Dr. David G. Brodland, past president of the American College of Mohs Surgery, says on the Skin Cancer Foundation’s website, “while a single Mohs surgery procedure includes all of these into one fee.” A single Mohs surgery is comparable in cost to and sometimes less than other treatment methods. Its success rate is significantly higher, and the likelihood of needed additional procedures is extremely low.

Is a plastic surgeon needed for reconstructive surgery after Mohs?

It depends on the case. One of the advantages of the Mohs technique is that it limits damage to healthy tissue, which in turn means the results are more aesthetically pleasing. Each wound is unique and there are options for repairing them. Some of the smaller wounds can simply heal on their own, but larger wounds require sutures or other repair techniques. Fellowship-trained Mohs surgeons undergo specialized reconstructive surgery training and can get excellent results on their own. In rare cases, patients may be referred to a non-Mohs surgeon who specializes in reconstructive plastic surgery.