Mohs Surgery: The Most Advanced Skin Cancer Treatment

Skin cancer is the most common form of cancer in the United States. Each year three million Americans are diagnosed with skin cancer, mostly basal cell carcinoma (BCC) or squamous cell carcinoma (SCC).

The number of new cases of skin cancer continues to rise every year. Early detection and treatment of skin cancer with Mohs micrographic surgery is your best option for definitive treatment with the best cosmetic outcome.

Mohs surgery removes all visible traces of the tumor while you wait in our office, providing peace-of-mind knowing that you have received the highest cure possible on that same day.

Our Fellowship-trained doctor, Dr John Strasswimmer, is a Fellow of the world’s oldest and most prestigious society of Mohs surgeons: The American College of Mohs Surgery. It is the only organization that requires its members, after their years of residency training, to successfully complete an extensive fellowship of at least one full year of hands-on training in the Mohs procedure under the supervision of a highly qualified instructor.

Mohs surgery is a multistep process. First, the skin cancer is removed by Dr. Strasswimmer while you are awake using local anesthesia. He then takes it to our state-of-the-art laboratory where he personally examines it under the microscope. Second, if he sees any skin cancer cells hidden that remain, he creates a map and returns to the room to remove any remaining roots, keeping the rest of the skin untouched. Finally, when he is assured the roots of the skin cancer are successfully removed, he will reconstruct the wound using the latest techniques to maximize your cosmetic outcome.

What is Mohs surgery?

Mohs surgery is a specialized treatment for removing certain types of skin cancers. Mohs surgery allows the Mohs Surgeon, a dermatologist who has completed advanced extra training, to remove all of the cancerous cells while you wait in our medical office. Mohs is the only treatment for skin cancer that allows complete evaluation of the margins (areas surrounding the visible skin cancer) while you wait. Mohs surgery ensures that all cancer cells have been removed before you leave our office.

Why choose Mohs for your skin cancer treatment?
  • Mohs micrographic surgery is the most effective and advanced treatment for skin cancer today.
  • Mohs surgery has the highest success rate of all treatments for skin cancer – up to 99%, according to the American College of Mohs Surgery
  • It offers the highest potential for cure – even if the skin cancer has been previously treated by another method
  • Mohs surgery is so successful because the way Dr Strasswimmer analyzes it while you wait, evaluating 100% of the surgical margins.
  • Generally, we are able to remove skin cancer completely, confirm using the Mohs pathology technique and reconstruct the skin all in one morning.
  • Extremely effective at removing basal and squamous cell carcinomas as well as more than 70 other types of skin cancer.
  • Removes cancerous cells while sparing as much normal tissue as possible. This can potentially mean less scarring than other methods such as radiation or an excision.
  • Performed in an outpatient setting, which means that you don’t need to spend the night in the hospital after surgery and do not have to pay an extra “facility fee” that could be incurred in a hospital or an ambulatory surgical center.
Who typically uses Mohs surgery?

Mohs surgery is used to remove basal cell carcinoma, squamous cell carcinoma, and more than 70 other types of skin cancers.  Mohs surgery can be performed on aesthetically sensitive body parts including the face, nose, ears, lips, fingers.  In cases where the skin cancer is large or has failed another attempt at treatment, it can also be used on the back, legs, or any other body part.

You remain awake during Mohs surgery and receive a local anesthetic to gently numb the surgical area instead of general anesthesia (which puts the patient to sleep).  This reduces recovery time with fewer side effects.

What exactly happens during Mohs surgery?

Your surgery will take place in our Mohs suite, which is a medical office designed especially for Mohs treatment.  The procedure begins by numbing the area with local anesthesia.  The surgeon then removes your skin cancer using a very sharp knife called a scalpel, and a temporary sterile bandage is placed.

Following the removal of the skin cancer, the surgeon checks for skin cancer cells under a microscope in our certified state-of-the art Mohs pathology laboratory, while you wait in our Mohs Suite, reading a book or relaxing.

If the skin cancer has hidden “roots”, Dr Strasswimmer will see them under the microscope and return to the room to remove more from that precise area.  He leaves the rest of the skin untouched.  This way all the skin cancer is gone while healthy skin is left behind to heal.

When he is satisfied that you are cancer-free, he will reconstruct the wound. He will discuss the different options to repair the wound at that time.

Typically Mohs takes 2-5 hours including removal, Mohs pathology testing, and reconstruction, but rarely may take longer.  The surgery times will vary depending on the size of the affected area and how many layers have to be checked for skin cancer cells.

What can I expect after Mohs surgery?

You will go home and relax for the rest of the day, applying ice packs to decrease swelling.  The wound takes about two weeks to heal and we will review with you the aftercare in detail.  Generally, you should not do any heavy lifting, exercise, golf, or hunting for two weeks.  The doctor will likely prescribe an antibacterial ointment or dressing to prevent infection, and an analgesic for mild pain relief.  Scarring is rare after surgery, but if it does occur, it’s generally very faint and unnoticeable. Your surgeon will see you back for follow-ups depending on the location and extent of the procedure.

You can typically return to work one day after surgery provided you do not do any lifting for two weeks.  If your job involves physical work, lifting or packing items, then please see if you can be placed on “light duty” for other type of desk work.

You will need to take care of the wound to make sure there is no infection and for maximum skin healing and recovery.

As detailed above, you can see Mohs surgery is the best treatment for selected skin cancers.  Our professional and knowledgeable staff, including our dedicated surgeon, are available to answer any questions

Montrose Mohs surgeon

Meet Your Mohs Surgeon: Dr. John Strasswimmer

Dr. Strasswimmer is a leader in skin cancer treatment and research for the last 15 years, with more than 40 publications to his name. In addition, he is invited as a speaker at dermatology symposia around the world.

He completed his medical and doctorate degrees from Tufts University, served an internship at Harvard Medical School in Boston Massachusetts and a Dermatology Residency at Yale University at Yale-New Haven Hospital.  He completed an additional one-year Mohs and Reconstructive Surgery Fellowship through the American College of Mohs Surgery.  Prior to working in private practice, he served on staff at Mass General Hospital (MGH) in Boston.

Find out if Mohs is the right treatment approach for your skin cancer diagnosis by scheduling your consultation today.