Mohs Surgery

For tumors with a high risk of recurrence, we may perform a highly specialized technique called Mohs surgery.

Mohs Surgery Seattle

Treatment for the most common skin cancers, basal cell carcinoma and squamous cell carcinoma, as well as some kinds of unusual skin cancers.

Mohs surgery or Mohs micrographic surgery is the gold-standard and most precise technique available for removal of most skin cancers and has the highest cure rate (98-99%). It treats skin cancers on the face where it is critical to remove the minimum amount of tissue for cosmetic and functional reasons and to ensure no tumor is left behind.

Mostly, it is a technique that allows the doctor to test the edges of the excision on the day of the surgery, while you wait. It will enable the doctor to remove the narrowest possible margin of healthy skin around the tumor, keeping the surgery site as small as possible.

Mohs micrographic surgery was named after its inventor, Dr. Frederick Mohs, an American dermatologist, and surgeon. A Mohs surgeon requires many years of medical and specialized training and, as such there is currently a shortage of Mohs surgeons in the Pacific Northwest, making Dr. Jenkin of Seattle Dermatology Associates of Seattle one of the top, leading, and the premier choice for personalized, full-service dermatology care.

Seamless and comprehensive mohs procedures

In Mohs surgery, the histological processing takes place on the day of surgery, and the incision is only closed after it has been confirmed that entire cancer has been successfully removed. The excision margin is examined by an embedding technique that allows horizontal sections to be cut involving all the low and radial excision margins. If any tumor is visible in these parts, it means that the excision is incomplete and the patient requires a further Mohs stage. A mapping process and color coding system is used during Mohs surgery to precisely localize any remaining cancer, and tissue is only removed if it contains cancer. This method preserves healthy tissue. Request a consultation to see if Mohs Surgery is best for you.

Our Mohs Treatment:

Mohs may also be appropriate when a significant reconstruction is needed to close the incision or with tumor removal procedures located in cosmetically sensitive areas.
In 2012, a joint effort by various medical organizations in the USA led to the development of appropriate use criteria for Mohs surgery. These requirements may be used as guidance when considering Mohs surgery although they may not apply in all jurisdiction.

Plenty of evidence supports that Mohs is the best form of surgery for high-risk basal cell carcinoma and squamous cell carcinoma. Large clinical trials comparing Mohs to standard excision for remaining types of skin cancer are lacking. Mohs surgery yields higher clearance rates than standard excision, and smaller incisions — therefore better cosmetic results. Mohs surgery is a single day procedure under local anesthesia which includes the following steps:

Step One:

The visible tumor plus a small margin is outlined using a skin marker, and a reference map or grid is drawn on the patient (often using temporary sutures).

Step Two:

The area is excised at the radial margins.

Step Three:

Haemostasis is obtained, and the incision is temporarily dressed.

Step Four:

The excised tissue sample is divided into two or more sections that are color-coded using special tissue dyes.

Step Five:

A mapping process ensures that a residual tumor seen under the microscope can later be matched to the exact location of the patient using a paper-based map or digital photographs and image processing software.

Step Six:

Our specialized biomedical scientists embed and freeze the tissue in a cryostat to create horizontal sections of the entire excision margin.

Step Seven:

The Mohs surgeon examines the microscopic sections for remaining cancer.

Types of skin cancer which are best treated with Mohs surgery:

Mohs surgery is the first choice of treatment for high-risk basal cell carcinoma and squamous cell carcinoma. One reason to perform Mohs is to minimize the risk of incomplete excision. Mohs reduces financial burdens to the patient helping avoid extensive and costly re-excisions later. [ Request a mohs pre-op consultation }

Mohs Surgery Results: Before & After

Seattle Mohs SurgeryBefore / After
Mohs Cancer SurgeryBefore / After
Moes SurgicalBefore / After