Mohs Surgery

If you’ve been advised to undergo Mohs surgery for skin cancer, rest assured you’ll be in highly-skilled and competent hands should you choose the top-rated team at Medical Dermatology & Cosmetic Surgery (MDCS).

With 3 locations in Hampton Bays, Commack, and Midtown East, Manhattan, our surgeons are lead by Dr. Snehal P. Amin, a renowned leader in the field who previously served as Director of Mohs, Laser and Dermatologic Surgery at New York Medical College and is currently Chief of Mohs Surgery at Cornell-New York Presbyterian Hospital in New York City.

Mohs micrographic surgery is the most effective treatment for basal cell carcinoma and squamous skin cancers, along with some melanomas. This meticulous and highly-technical procedure enables the removal of all cancer with the least risk for recurrence and the least amount of scarring possible. Reducing the potential for scarring is key, since of the 1.2 million people in the United States who are diagnosed with skin cancer each year, 80% have tumors on their face, including eyelids, lip and ears.

Whether you’re considering our practice for your surgery or have already booked a date with us, we encourage all patients to schedule a consultation with one of our surgeons beforehand, so we can explain exactly what to expect before, during and following your procedure.

The Mohs method

The traditional approach to removing skin cancer entails cutting out the tumor and a portion of healthy surrounding tissue with a scalpel and closing the wound with stitches. The excised skin is then sent to an outside lab for analysis. Depending on the results, which can take several days to receive, additional surgery may be needed to dig out stubborn tumor roots.

By contrast, in Mohs surgery, named after Dr. Frederick Mohs who developed the procedure in the 1930s, one thin tissue of skin is removed at a time. After each layer is removed, it’s examined under a microscope in our own lab to determine if any cancer cells are present. Layers of skin are meticulously removed and examined in this fashion, one at a time, until the final layer expunged is cancer-free. This is referred to as “clear margins.” Mohs surgery enables the surgeon, who must be specially-trained in the procedure, to remove all cancer while preserving the greatest amount of healthy surrounding tissue as possible. Performed in the office under a local anesthetic, Mohs surgery generally takes 2-3 hours to complete.

Mohs surgery advantages

Mohs surgery offers patients a number of advantages. Most importantly, it boasts a cure rate of 95-99%, versus a 60-90% cure rate for traditional surgery. In addition, the extra margin of healthy skin excised in traditional surgery means a larger wound and larger scar. Another benefit: The entire procedure is completed simultaneously during a single appointment by one surgeon, instead of waiting days for lab results that may indicate the need for further surgery. Mohs surgery is especially recommended for cancer that is:

• Large
• In which the edges cannot be clearly defined
• In which prior treatment has failed
• Located in a cosmetically sensitive or functionally critical area of the body

Wound repair and recovery

Once all skin cancer has been completely excised, Dr. Amin and his team will discuss the best technique for repairing the surgical wound. Small wounds are often left to heal on their own; others may need stitches. Larger wounds may require a skin flap or graft. In rare instances, an outside surgeon such as an otolaryngologist or an oculoplastic surgeon, will be brought in to assist with the repair.

Afterwards, we recommend that patients rest at home. Recovery is quick though, and most patients return to work the following day. However, we advise refraining from exercise or travel for 1-2 weeks after surgery, to speed healing and minimize scarring.