Mohs Surgery – Precision Treatment

Mohs micrographic surgery is an effective, meticulous technique that offers the highest cure rates (and the smallest wounds) for most skin cancers. Dr. Beth Goldstein specializes in the surgical procedure in Sanford and Chapel Hill at Central Dermatology Center. Dr. Goldstein is a Fellow of the American Society for Mohs Surgery. Named after the physician who developed the procedure in the 1930s, Dr. Frederic E. Mohs, the surgery is most often used to treat squamous cell and basal cell carcinomas. They are the most commonly diagnosed types of skin cancer.

If you have a suspicious lesion that might be skin cancer and live in Raleigh-Durham, Cary, Sanford or surrounding areas, request an appointment online, or call our office at (919) 401-1994 to schedule an appointment.

How Does Mohs Surgery Work?

The Mohs technique involves the precise excision of cancerous cells while leaving intact as much of the surrounding healthy tissue as possible. It’s a meticulous, step-by-step process:

  • First, your surgeon maps the lesion and determines how much tissue to remove. We create a diagram that matches precisely with the lesion, as shown in this illustration.
  • Then, using local anesthesia, we remove a layer of cancerous cells from the lesion.
  • Next, we then examine the cells and the margins surrounding them under a microscope. If the margins are cancer-free, the procedure is finished.
  • If there are signs of cancerous cells in the margins, we use the map to excise and examine another layer of skin cells from the exact spot. We continue these steps until we find clear margins.
  • Finally, we treat the wound that is left behind.

By removing the lesion layer-by-layer instead of removing a large area, we can preserve healthy tissue, often leaving behind a smaller scar than what would be required by traditional excision methods. As an additional benefit, Mohs surgery allows our team to say with certainty that all cancerous cells have been removed. This is why Mohs has such a high cure rate and low revision rate.

In this 6-minute video, you can learn in-depth about Mohs surgery, including a step-by-step overview of the surgical process, potential risks, and benefits.

Should I Have Mohs Surgery?

Mohs surgery has a cure rate of nearly 99% for most skin cancers being treated for the first time. For recurring cancers, the cure rate is still quite high at 95%. It’s a safe procedure with very few potential complications. Because it spares the most tissue of any skin cancer treatment, there’s less potential for disfigurement or scarring. So why wouldn’t anyone diagnosed with skin cancer have Mohs surgery?

Although it’s a versatile, extremely effective procedure, Mohs surgery is especially ideal for certain patients. These include:

  • Patients whose lesions have recurred after a previous excision
  • Patients who have lesions in delicate areas where it’s desirable to spare as much tissue as possible, including the eyes, ears, lips, nose, hands, genitalia, and feet
  • Patients who have aggressive, large, or fast-growing lesions

Mohs surgery is quite effective at treating and curing the most common forms of skin cancer, but the process of mapping and examining cells under a microscope can be time-consuming. Therefore, we recommend traditional surgical excision or other procedures for lesions that are not likely to recur or are not particularly advanced.

To learn whether you are a candidate for Mohs surgery, we encourage you to contact us for an exam.

Dr. Beth Goldstein, Dr. Jennelle S. Williams, Dr. David T. DeVries, Dr. Rebecca Todd-Bell, Dr. C. Lynn Cheng, Dr. Nadia Wang and Dr. Austin Newsome are all board-certified Dermatologists and members of the American Board of Dermatology. At Central Dermatology Center, we specialize in the following areas:  the prevention and treatment of skin cancer, the treatment of acne and acne scars, aging skin and wrinkles, hair loss, eczema, rashes, moles, cysts, lesions, rosacea and redness.  CDC serves patients throughout North Carolina, including Chapel Hill, Raleigh-Durham, Cary, and Sanford.