Mohs Surgery

This method, invented in the early 1940s by Dr. Mohs, allows the removal of skin cancer under complete microscopic control (using microscopic control, the Mohs surgeon can trace out the extent of the tumor and remove only diseased tissue).

Today while the Mohs technique has gone through many permutations, it is still centered on the complete removal of the skin cancer allowing for the smallest surgical defect and the highest cure rate, approximating 100%.

Mohs micrographic surgery has become recognized worldwide as the treatment, which results in the best cure rate for skin cancers. In order to assure the maintenance of high quality results for the patients Mohs surgery fellowships accredited by the ACMMSCO (American College of Mohs Micrographic Surgery and Cutaneous Oncology) have been created. There, a board certified dermatologist spends one to two years, training one-on-one, with an accredited ACMMSCO Mohs surgeon performing under the directors’ supervision over 1000 Mohs cases.

Indications:
Mohs surgery is indicated for the most common skin cancers such as basal cell carcinoma (BCC), Squamous Cell Carcinoma (SCC) and other tumors located in areas where functionality or aesthetics requires the highest degree of healthy tissue conservation and/or the highest cure rate. Mohs surgery is also indicated in certain special types of cancers with high risk of aggressive or subclinical growth (eg. morpheaform BCC, superficial spreading BCC). Other indications include skin cancer in young or immunosuppressed individuals, history of recurrence, rapid or aggressive growth, large size or indistinct clinical margins.

Consultation (What to expect):
Once you have been diagnosed with a skin cancer by your treating physician he would recommend Mohs surgery when appropriate. Our treatment and consultation are usually performed on the same day, unless otherwise requested by the patient and/or physician. During the consultation Dr. Levit again reviews all the possible approaches available to treat your skin cancer, as outlined in the book chapter he coauthored in Conn’s Current Therapy 2002.

To download please click here – Cancer of the Skin.

Surgery (What to expect):
The skin cancer location is marked, confirmed with the patient, and then gently anestheized (nummed). Once the area is nummed, a thin layer of skin is removed and the map of the site is drawn and oriented in a clockwise fashion. The tissue is then taken to the lab (located on the same floor as the surgery suite), marked, and processed in a special method, in order to allow Dr. Levit to completely examine its edges and undersurface under the microscope.

If skin cancer is present at the edge or the base of the skin biopsy examined, Dr. Levit removes another layer of skin from the exact location where the cancer was still present while avoiding the removal of the health tissue. This way, under microscopic control, the extent of the skin cancer can be traced out and only the diseased tissue removed.

 

Once the margins are clear Dr. Levit reviews with you the best possible ways for the site to heal. Usually the site is sutured immediately, unless otherwise requested by you or your referring physician.

Dr. Levit has undergone 2 extra years of fellowship, beyond his 1 year Mohs surgery fellowship, where he further perfected his cosmetic reconstructive skills. View  Dr. Eyal Levit CV

The sutures are usually removed in 1 to 2 weeks after and can be removed by your referring physician or at our office.

While Dr. Levit will always be available for any questions regarding the surgery he performed, any other skin care and future skin exams must be performed by your primary dermatologist.