Mohs Micrographic Surgery
Dr Lee is a Mohs Micrographic Surgical Specialist of the Australasian College of Dermatologists and American College of Mohs Surgery. Mohs surgery is a highly specialised technique for the removal of skin cancers such as basal cell carcinomas (BCC) and squamous cell carcinomas (SCC).
Some skin cancers are like an octopus; the head is easily seen with the naked eye however the “tentacles” which are not visible to the naked eye grows downwards and outwards into the skin. Mohs surgery allows these areas to be detected under a microscope and maximises the chance of cure.
What does Mohs surgery involve?
On the day of your surgery, Dr Lee will mark out the area of concern. Mohs surgery is performed under local anaesthetic. Once the area is numb, Dr Lee will remove the first layer, with its edges marked with coloured dyes and a map of the specimen is made. The tissue is then processed by a medical laboratory technician onto microscope slides in the laboratory. Dr Lee then reviews the slides under a microscope looking for any evidence of skin cancer. During this time, the area of concern will still be numb and have a dressing over it. You will be placed in a comfortable private area during this time. If Dr Lee identifies any cancers cells after he has taken the first layer, then an additional layer will be removed only in the area where the cancer cells have been detected, leaving normal healthy skin intact. This maximises your chances of cure and minimises removal of healthy normal skin.
Once the cancer has been fully removed, the wound may be closed with sutures in a side-side manner, or with a flap or graft. Dr Lee or a plastic and reconstructive surgeon may perform the second stage of closing the wound.
How long does Mohs surgery take?
While it may be difficult to predict, due to the nature of your skin cancer, Mohs surgery typically takes several hours.
My skin cancer is less evident after I have had the biopsy. Do I still need Mohs surgery?
Sometimes your skin cancer that has been biopsied may be less evident. This does not necessarily mean the cancer is all gone. The biopsy may represent the “octopus head” and the “tentacles” may still remain in the skin, which is just not visible to the naked eye. The residual cancer cells may give rise to daughter cells over time and re-appear sometime later, which may require more extensive surgery.