Mohs Surgery
St. Louis MO

Why is it called Mohs surgery?

Mohs surgery gets its name from Dr. Frederic Mohs, who pioneered a procedure called chemosurgery for skin cancer back in 1936. Initially, a zinc chloride solution was used to “fix” the excised skin tissue for study under the microscope, but the chemical caused serious discomfort to the patient. So, in 1953, Dr. Mohs tried the same technique of removing a minimal amount of tissue and examining it for remaining cancer, but he now eliminated the zinc chloride. This was called the fresh tissue version and became Mohs surgery. The surgical method began to be adopted by the dermatology community starting in 1970. Today it is the gold standard for removing skin cancer with the least disfiguration, and the highest rates of success.

How is Mohs surgery done?

Mohs surgery with Dr. Steitz is done on an outpatient basis. Once the area has been anesthetized, Dr. Steitz will remove the visible portion of cancer along with a thin, underlying layer of tissue slightly beyond the borders of visible cancer. This takes just a few minutes.

He then applies a temporary bandage over your incision, and you head to a waiting room to wait while the removed tissue is sent to the laboratory for examination. This will usually take about one hour. It’s good to have a book or laptop to pass the time.

In the lab, your tissue is cut into sections and examined under a microscope. A map of the excised tissue is created to show what areas, if any, still have cancer cells. Then Dr. Steitz knows precisely where more tissue must be removed.

If there is still cancer present, another round of Mohs surgery is done. More tissue is removed, this time only in the area where cancer cells were still present. It is again sent to the lab and the process repeated.

This process is repeated until the tissue borders are all cancer-free.

“I cannot say enough positive things about Dr. Steitz and his team. Beautiful office, friendly and helpful staff, you are comfortable from the moment you walk in. Dr. Steitz takes his time to explain everything to you, answer all questions, give you pros and cons, and takes his time during the consultation. He is honest, personable, and straight forward.”

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Who is a good candidate for Mohs surgery?

Skin cancer lesions need to be removed, regardless of the type. Mohs surgery is far and away the best option for treating most basal cell carcinomas and squamous cell carcinomas. This is especially true if your lesions are in cosmetically and functionally important areas around your eyes, nose, lips, ears, scalp, fingers, toes, or genitals. Mohs is also recommended for basal cell and squamous cell cancers that are large, aggressive, or growing rapidly, that have indistinct edges, or have recurred after previous treatment.

Why does my skin cancer need to have Mohs surgery?

Mohs surgery with Dr. Steitz is the most precise method for removing a skin cancer lesion. These lesions cannot be left in place, as they can spread or simply grow larger and become quite disfiguring.

There isn’t any downside to using Mohs methods to remove a squamous or basal cell carcinoma. It can also be used in some cases of melanoma.

These are the situations where Mohs can be especially useful:

  • The skin cancer has recurred or there is a high risk of recurrence
  • The skin cancer is located in areas where it’s important to maintain as much healthy tissue as possible: around the eyes, nose, mouth, hands, ears, feet, and genitals
  • Skin cancer has borders that are hard to define
  • The skin cancer is large
  • Skin cancer is aggressive

How long will my Mohs surgery take?

When Dr. Steitz performs these surgeries there isn’t a “set” or average timeframe. The duration of your surgery depends upon the number of rounds necessary to find a clear border. If more than one or two rounds are necessary, the entire process can take up to several hours. It’s worth it, though, considering Mohs takes the least amount of tissue but has the highest cure rate of any treatment method.

Due to the testing phases, Mohs surgery involves a lot of downtime for the patient, as he or she waits for the lab results to see if the outer ring was clean. During these times, the patient can read, watch videos, or even leave the room.

Will Mohs surgery leave a scar?

Any time an incision is made in human skin it will create a scar. That’s simply the way collagen heals the skin. But that’s the beauty of Mohs surgery; it limits the amount of tissue that is removed, enabling Dr. Steitz to preserve as much healthy tissue as possible, while still being able to be sure that he has removed all of the cancer cells.

Contrast that with other excisional methods for removing skin cancer growths. It’s typically necessary to remove a wider border around the lesion so that hopefully all of the cancer cells are taken. Because there isn’t immediate testing of the borders, surgeons need to err on the safe side by taking more healthy tissue. This, of course, creates a larger area that needs to heal.

Dr. Steitz has extensive training and experience with Mohs micrographic surgery ensuring you’ll have the smallest scar possible. He is also excellent with subsequent options for minimizing your scarring, such as the possible use of a skin flap.

How effective is Mohs surgery?

Mohs surgery has the lowest recurrence rates, highest cure rates, and best cosmetic results of any skin cancer treatment, according to the Skin Cancer Foundation. Mohs surgery has over a 99 percent cure rate on skin cancers that were not previously treated. On areas that were previously treated with other excision methods and the cancer was not fully removed, Mohs is 94 percent successful.

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If you’re interested in learning more about Mohs surgery please contact us for a consultation at 314.475.3700 or fill out our contact us form. We will discuss your needs and concerns, and determine your best course of action.

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