Bowling Green – Glasgow – Russellville – Franklin

Learn about the advantages of MOHS Surgery

MOHS Surgery is the most advanced form of dermatolgy surgery available.

It allows for an experienced surgeon to examine the layer of skin during the procedure to ensure best possible chances all cancer is removed. This allows us to remove the least amount of the infected area, resulting in minimal scarring.

What are the advantages of Mohs?

By using detailed mapping techniques and complete microscopic evaluation, the physician can pinpoint residual skin cancer areas that are otherwise invisible to the naked eye. Therefore, even the smallest microscopic roots of the cancer can be removed. This results in the following: highest cure rate possible, least amount of healthy uninvolved tissue removed from the patient, and, in most cases, a procedure which is performed in one day.

What is Mohs Micrographic Surgery?

Mohs surgery is a highly specialized procedure used to remove skin cancer, most commonly basal cell and squamous cell carcinoma. Mohs surgery is named in honor of Dr. Frederic Mohs, the physician who developed the technique. It is typically a one day, outpatient procedure which involves the selective removal of skin cancer while maintaining as much uninvolved surrounding tissue as possible. This technique differs from other methods by microscopically evaluating the entire margin/edges to ensure adequate and complete tumor removal. Using detailed mapping techniques, the physician can pinpoint areas of persistent tumor and return to the exact location on the patient in order to remove more involved tissue. Thus, the patient has the advantage of a 99% cure rate for primary non-melanoma skin cancers (i.e. basal cell and squamous cell carcinoma) while limiting the amount of tissue removed from the patient. After the skin cancer is removed, the physician will reconstruct the area in the most cosmetically appealing manner. 

Mohs surgery instructions

what to expect on surgery day

Here is what to expect when you arrive.

First, you will be escorted to a surgical suite where you will be given a patient gown to wear if needed. A medical assistant will record your blood pressure and take a focused history by asking you a few questions. Then, you will review and sign a consent form.

Next, Dr. Cowan will enter the room and this is your opportunity to ask any remaining questions you may have before surgery. The lesion that is being removed will be marked and anesthetized using a small caliber needle. Patients are usually amazed at how little discomfort they feel. Then, all instruments will be arranged and the surgical site will be prepped and sterilized.

Next, the lesion will be surgical excised by Dr. Cowan. Bleeding will be controlled using a device called electrocautery. It stops bleeding by passing a small amount of electric current only through the tissue it touches (you will not feel any discomfort). Electrocautery creates heat which singes the blood vessels and stops any pinpoint bleeding. Since it generates heat, the patient sometimes will notice a distinct burn odor. This is very normal and there is no reason to be alarmed. Stitches (or sutures) are placed to bring the sides of the wound together. Finally, a bandage is applied and wound care is discussed. Any necessary topical and/or oral medications will be given along with a follow-up appointment in a couple of weeks after the surgery. The specimen is sent to an outside agency where a board-certified dermatopathologist will review the specimen to ensure the skin cancer or growth was completely removed.