Mohs surgery is a precision surgical technique that is often used to treat skin cancer. This surgical method is designed to remove as much of the cancerous tissue as possible while protecting surrounding healthy skin from damage. At NYDG, our experienced and knowledgeable surgical staff members can provide you with Mohs surgery solutions that can help you look and feel your best. Here are some basic facts you should know about Mohs micrographic surgery for skin cancer.

Unlike traditional excision methods that remove the cancer along with a portion of healthy tissue, Mohs surgical techniques remove thin layers progressively to reduce the amount of damage done to healthy tissues surrounding the area of the cancer. Our doctor will look at each removed skin layer under a microscope to determine if cancer cells are present. This minimizes the amount of healthy tissue that will be lost when cancerous cells are removed, which can significantly speed the healing process while protecting your appearance. This procedure can generally be completed on an outpatient basis and requires only a local anesthetic, which makes it a great choice for busy professionals. Also known as Mohs micrographic surgery, this surgical procedure is useful in treating skin cancers of the nose and face.

Mohs micrographic surgery is suitable for most common types of skin cancer, including the following varieties of this skin condition:

Basal cell carcinoma: Basal cell carcinoma is a form of skin cancer that starts at the surface of skin and grows slowly into the skin. By removing layers of skin carefully during the Mohs surgery procedure, your surgeon can limit the amount of damage done to skin surrounding the basal cell carcinoma.

Melanoma: Melanoma is a form of cancer that affects the melanocytes, the specialized cells that produce melanin within the skin. Mohs surgery can remove melanoma cancer cells while reducing the damage caused to normal and healthy tissue.

Squamous cell carcinoma: Squamous cell skin cancer is often associated with excessive exposure to ultraviolet rays. This type of cancer is more common among older people and those with very fair skin.

Sebaceous carcinoma: One of the rarest types of skin cancer, this condition affects mostly adults between the ages of 60 and 80. Risk factors can include past radiation therapy, exposure to ultraviolet rays from the sun and a weakened immune system.

Mohs micrographic surgery can be used to treat other cancers of the skin. Your dermatologist will discuss the options with you to determine if these surgical procedures are the right choice for you.

Your surgeon may recommend some simple steps to help you prepare for your surgical procedure in the NYDG clinic. Some of the most common precautionary measures include the following:

• Your surgeon may recommend that you stop taking certain over-the-counter or prescription medications to allow your body to prepare for the surgical procedure. These may include blood thinners and other medications that could affect your blood chemistry.

• Allow for a full day at the doctor’s office. Most Mohs surgical procedures take four hours or less. It is possible, however, that your specific case may require more time. Your surgeon will need to analyze each layer of tissue before proceeding with your surgery, which can cause long delays between each of the surgical incisions. You may wish to bring along a book or handheld device to occupy your time during these pauses or gaps in your surgical procedure.

• Dress in layers. Wearing clothing that can be adjusted to suit the ambient temperature indoors is often a good starting point for ensuring that you stay comfortable throughout your procedure.

Your surgeon will be your best source of information on the right preparations for your upcoming Mohs surgery. By following the instructions provided by NYDG, you can enjoy the greatest comfort and the best results from your Mohs surgical appointment.

Once the skin cancer has been removed, your doctor will typically use one of four methods to close the incision:

• If the area affected is small, your surgeon may choose to let it heal naturally.

• Stitches may be used to close the incision.

• A skin flap may be created to cover the area affected by your Mohs micrographic surgery.

• In some cases, a skin graft may be needed to cover the wound and to ensure the fastest healing for your surgical site.

Your surgeon will discuss these options with you before your procedure and will opt for the most appropriate treatment to reduce scarring and to promote faster healing.

At NYDG, Dr. Daniel Belkin is the resident specialist for Mohs Surgery. Dr. Belkin is a board-certified dermatologist who is fellowship-trained in Mohs micrographic surgery, laser surgery, and cosmetic dermatology. After receiving his medical degree from Weill Cornell Medical College, he trained in dermatology at the University of Southern California in Los Angeles. He went on to complete a prestigious fellowship in Mohs and procedural dermatology at the Laser & Skin Surgery Center of New York. He has authored several textbook chapters on dermatologic surgery and multiple original articles. He is a fellow of the American Academy of Dermatology and the American Society of Laser Medicine and Surgery, and a member of the American Society for Dermatologic Surgery and the American College of Mohs Surgery.