Mohs Surgery FAQs

Mohs micrographic surgery is the most effective and advanced treatment for skin cancer today. When choosing a Miami Mohs surgeon, you want someone with the highest skills and training such as Dr. T.J. Giuffrida. Dr. Giuffrida is fellowship trained in Mohs micrographic surgery and provides this service in his Miami dermatology office. Dr. Giuffrida is highly respected in all of South Florida and will provide excellent, competent, and compassionate care.

Why is it called Mohs?

The term “Mohs” refers to Dr. Frederic Mohs, Professor of Surgery at the University of Wisconsin, who developed this surgical technique in the 1930s. The technique has undergone many refinements and has come to be known as “Mohs micrographic surgery” or simply “Mohs surgery” in honor of Dr. Mohs.

What is Mohs surgery?

Mohs micrographic surgery is the most effective and advanced treatment for skin cancer today. This procedure is an exact and precise method of tumor removal in which the physician serves as surgeon, pathologist, and reconstructive surgeon. It relies on removing the cancer in stages, one tissue layer at a time and visualizing the tumor with a microscope to trace and ensure removal of the skin cancer down to its roots. The goal of the procedure is to precisely identify and remove the entire tumor, leaving healthy tissue unharmed, thus minimizing the chance of regrowth and lessening the potential for scarring or disfigurement. It is most often used in treating two of the most common forms of skin cancer: basal cell carcinoma and squamous cell carcinoma.

How is Mohs surgery like other surgery?

The Mohs surgeon uses conventional surgical instruments and removes malignant tissue during surgery.

How is Mohs surgery different than other types of surgery?

The difference is what happens to the tissue after it is removed. The specific technique of tissue examination used in Mohs surgery is unique. Although other surgical specialists may check excision margins, this form of pathologic examination of the tissue is not the same as Mohs surgery.

In other therapies, the physician must make an educated visual estimate about the size of the tumor and the margins outside the tumor that must be removed for safety. This may prove ineffective and can lead to having to repeat the procedure soon after or to a return of the tumor later.

How effective is Mohs surgery?

It offers the highest potential for cure – up to 99% for new skin cancers and 95% for cancers that have already been treated.

I don't see anything after my biopsy. Do I really need treatment?

Yes. Following a biopsy, your skin cancer may no longer be visible. However, the surface lesion that was removed can represent the “tip of the iceberg.” More tumor cells may remain and these can continue to grow, like roots of a tree. These “roots” are not visible but if they are not removed, the tumor will likely reappear and require more extensive surgery. On rare occasions, these cancerous cells can metastasize to lymph nodes and other organs in the body.

Why does my skin cancer require Mohs surgery?

Mohs surgery is has the highest cure rate and is primarily used to treat basal cell and squamous cell carcinoma, but can occasionally be used to treat less common tumors.

Mohs Surgery is indicated when:

  • The cancer is in an area where it is important to preserve healthy tissue for maximum functional and cosmetic result, such as eyelids, nose, ears, lips.
  • The cancer was treated previously and has come back
  • Scar tissue exists in the area of the cancer
  • The cancer is large
  • The edges of the cancer cannot be clearly seen
  • The cancer grows rapidly or uncontrollably
  • The cancer exhibits aggressive pathology under the microscope
  • The patient is immunosuppressed (such as those with organ transplants or lymphoma)

What is Mohs surgery?

Mohs surgery is has the highest cure rate and is primarily used to treat basal cell and squamous cell carcinoma, but can occasionally be used to treat less common tumors.

How long does Mohs surgery take?

The entire procedure usually lasts between 1 to 5 hours. If you prefer to have a consultation with the Dr. Giuffrida prior to your procedure, he may be able to give you a more clear estimate as to the extent of the timeframe for your surgery.

Will Mohs surgery leave a scar?

Yes. Any surgical treatment for skin cancer will leave a scar. A benefit of Mohs surgery is that it removes only the cancerous cells and preserves as much normal, healthy skin as possible which helps to minimize scarring.

Surgical scars improve with time and can take up to 1 year to fully mature. Redness, bumpiness, and hardening of the scar can occur but these are usually a normal part of healing and resolve with time. Dr. Giuffrida is available to all patients throughout the healing process.

Will I need stitches?

Dr. Giuffrida and you will determine how the wound will heal best after the cancer has been removed. Dr. Giuffrida is highly skilled in reconstructive surgery for repairing the wound.

Usually the surgical area is reconstructed with sutures to try to achieve the best possible cosmetic and functional results. This is typically done the same day as the cancer removal. Stitches can be used primarily in three main ways:

1. Direct closure of the wound in which edges are sutured together side to side.

2. Skin grafting in which skin is removed from another area of skin and this is then placed over the surgery site wound.

3. Skin flap is closing the wound with skin adjacent to the wound

In certain cases the wound may be allowed to heal on its own. On rare occasions, Dr. Giuffrida may refer the patient to another reconstructive surgical specialist.