Mohs Micrographic Surgery

The single most effective technique for removing Basal Cell Carcinoma

Precise surgical technique to treat skin cancer

Mohs surgery allows for the removal of a skin cancer with very narrow surgical margin and a high cure rate. The technique is especially used to operate skin cancer in the face with an unpredictable growing pattern.

The operation

The operation is done in the treatment room. You take place in a comfortable surgery chair. Together with you the right spot is indicated. After disinfecting the skin the dermatologist marks the spot and local anaesthesia is given. This can be a little painful. Some stitches can be applied for orientation. Than the dermatologist cuts out the skin cancer.

This piece of tissue is taken to the laboratory to be processed. In the meantime your operation wound is bandaged and you can wait calmly in our living room until the dermatologist has examined your skin under the microscope. If the skin cancer is still not quite removed, you will lie down in the surgery chair again and another piece is cut away. The wound is bandaged and you can stay in our living room again. This procedure will be repeated until the skin cancer has been removed completely. When the skin cancer has been removed completely, you will once again take place in the surgery chair and the dermatologist will discuss the possibilities to close the wound. This might be done with simply approximating and stiching the edges of the wound. If this is not possible, skin of somewhere else will be used; this can be done by shoving skin or by transplanting skin from another place. Sometimes the defect is not closed and we let it heal spontaneously.

The expected results

The Mohs technique is especially used to operate skin cancer in the face with an unpredictable growing pattern. This can mean that the arisen defect is bigger than what you had imagined. However, you can be sure that no superfluous healthy skin has been taken away as we let the microscope lead us and take only skin there where the skin cancer exists.

After every operation there will be a scar. Depending on the place of the operation, the size of the wound and your own natural ability of healing, this will be visible more or less. If you are not satisfied about the final result, the dermatologist, together with you, will look for a solution. 

The risks

The risk of a serious complication is minimal. If you are allergic to anaesthetic fluids you have to let us know every time.

Bleeding

Blood comes from under the bandage. Press your flat hand firmly and continuously on the bandage for 20 minutes. If the bleeding does not stop, again press on the bandage for 20 minutes continuously. If it keeps bleeding, contact us or your family doctor.

Infection

After some days the operated area starts to hurt and looks red, or you get a fever. Contact us. If the scar gets thicker or does not look nice, make an appointment with your dermatologist in Mohs Clinics.

Some rules for after the operation

  • take it easy; do not lift heavy objects; do not bend forward; do not do sports; avoid heavy perspiring
  • if you are in pain you can take paracetamol. Do not take aspirin or acetylsalicylic acid
  • do not make the bandage wet! This increases the chance of infections
  • if you have been operated in the face, you can best sleep with the head of the bed a little upwards

Remark

A Mohs surgery can take a few hours to a whole day. Between the operations you can rest, read or work on your laptop. If you are with us during lunchtime we will order a sandwich for you. Coffee, tea and non-alcoholic drinks will be offered to you. For your rest and that of other patients we ask you to take only one accompanying person with you.


Other dermatologic surgery techniques

Skin tumors or moles can be removed in several ways. One of the most applied forms is excision. With this the skin with the disorder is cut away and sutured.

a treatment with which the malignant skin cells are made extremely sensitive to visible light. Then the malignant cells are exposed to light by which they die. After several weeks they are replaced by new, healthy skin cells. This special selective effect on only tumour cells makes photodynamic therapy an eminent and for this tumour, attractive treatment. It is important to know that this therapy is not suitable for every form of skin cancer.

With this treatment a liquid is injected into the varicose vein. This “soaplike” liquid causes an inflammatory reaction in the walls of the blood vessel by which they start sticking together with the result that the varicose vein wastes away. For the bigger varicose veins a foam is made of the liquid. The foam is better for the treatment of the bigger veins.

The treatment is cosmetically attractive because no scars are made. Also no sedation injection needs to be given. A big advantage of this treatment is the short time of treatment: the whole treatment takes about 15 minutes. After the treatment you wear therapeutic, elastic support stockings for 2 days up to a week, depending on the size of the treated varicose veins.

The essence of this treatment is that a laser thread is placed in the vein which is treated, then the vein is cauterized and closed by the laser beams. This treatment is not suitable for all varicose veins and is only executed on big, not too twisted varicose veins.

The ideal treatment of varicose veins depends on different factors. Varicose veins can be treated by means of laser, injection or operation such as ambulant phlebectomy (Muller technique). For medium sized varicose veins which have returned after an earlier operation the ambulant phlebectomy is often the most appropriate treatment. This treatment can be applied in combination with other possibilities of treatment.