What is Mohs Surgery?
BDS (Bachelor of Dental Surgery), 10 years of experience
What is the meaning of Mohs Surgery?
A surgical technique used for the treatment of skin cancer is known as Mohs surgery. In Mohs surgery, thin layers of cancer-containing skin are removed progressively and examined till cancer-free tissue remains. It is also known as Mohs micrographic surgery. Mohs surgery is done for the removal of as much skin cancer as possible while causing minimal damage to the surrounding healthy tissue.
In this article, we will be discussing Mohs surgery in detail –
- What is the purpose of Mohs Surgery?
- What is the diagnostic procedure before Mohs Surgery?
- How to prepare for Mohs Surgery?
- What is the procedure for Mohs Surgery?
- How to care after Mohs Surgery?
- What are the risks of Mohs Surgery?
- What is the cost of Mohs Surgery in India?
What is the purpose of Mohs Surgery?
Mohs surgery is mostly used to treat the two most common forms of skin cancer, namely basal cell carcinoma and squamous cell carcinoma.
Mohs surgery can also be used for the treatment of aggressive and rare types of skin and soft tissue cancers. It is particularly helpful in treating the following conditions:
- Skin cancers present near the important cosmetic or functional areas like the nose, ears, eyelids, forehead, lips, scalp, fingers, or genital areas.
- Skin cancer equal to or greater than one inch in size on an area other than the face.
- Skin cancer has borders that are not defined clearly.
- Recurrent skin cancers that come back even after other forms of treatment.
- Skin cancer in areas having the presence of scar tissue.
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What is the diagnostic procedure before Mohs Surgery?
- Physical examination: Skin changes are examined by the doctor, which may be the likely signs of skin cancer.
- Biopsy: The doctor will remove a small sample of the suspected skin tissue and send it to the laboratory to check if a person has skin cancer and if present, what type of skin cancer is present.
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How to prepare for Mohs Surgery?
- The doctor should be informed about any medicines or supplements you are taking.
- Tell your doctor if you are suffering from any pre-existing medical illnesses.
- You may be advised to stop taking blood-thinning medications like warfarin and aspirin a few days before the procedure, to reduce the risk of bleeding.
- Stop smoking at least a few weeks before the procedure.
- Wear comfortable clothes on the day of the procedure.
- Avoid the consumption of alcohol a few days before the surgery.
- Clear your schedule for the entire day, as the surgery may take a couple of hours to complete.
- Carry a magazine, book, or another activity to pass time.
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What is the procedure for Mohs Surgery?
- This is an outpatient procedure, which means that the patient can go home on the same day of the surgery.
- The area of operation is first cleaned.
- The doctor injects the operation area with local anesthesia, which numbs the area and prevents any discomfort during the procedure.
- The surgeon removes the visible part of cancer along with an underlying, thin layer of tissue slightly larger than the tumor that is visible using a scalpel or surgical blade.
- A temporary bandage is put on the incision (cut) area.
- The excised tissue is sent to the laboratory for analysis.
- The patient needs to wait in the waiting room, while the excised tissue is cut into different sections and examined under the microscope.
- The exact spot of each part of the tissue removed is marked by the surgeon by making a map. This helps the surgeon in knowing precisely in which part to continue the surgery.
- If cancer still remains, Mohs surgery will continue. The surgeon then removes an additional tissue layer from the affected area, while leaving as much healthy tissue as possible intact.
- The tissue removed is again examined in the laboratory, while the patient is made to wait for the results.
- The procedure is repeated till the last tissue sample removed is free of cancer.
- Local anesthesia may be re-injected or required.
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How to care after Mohs Surgery?
- Once all of the cancer has been removed, the surgeon will repair the wound depending on the extent of the operation. This may include:
- Primary closure: Sutures or stitches are used to close the wound.
- Healing by second intention: The wound is allowed to heal on its own.
- Skin flap: The skin from an adjacent area is shifted to cover the wound.
- Skin graft: The skin graft from another part of the body, like behind the ear, is used for covering the wound.
- Reconstructive surgery: In case of extensive or complex surgery, the doctor temporarily closes the wound and refers the patient to a plastic surgeon for reconstructive surgery in order to repair the wound.
- Avoid strenuous activities for some days after the procedure.
- The surgical site is covered by a bandage that should be left in place for 24 to 48 hours.
- The doctor will instruct you when to remove the bandage and the type of wound care that can be used.
- The doctor normally advises the use of an ice pack for wound healing.
- The doctor may recommend taking pain-relieving medications and antibiotics to ease the discomfort and prevent infection after the procedure.
- It is normal to have some discomfort and bleeding after the procedure.
- Follow-up appointments with your doctor are a must to check for recurrence of skin cancer.
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What are the risks of Mohs Surgery?
The complications associated with Mohs surgery are:
- Infection
- Bleeding
- Tenderness or pain
- Numbness around the surgical area, which may be permanent or temporary, if the small nerve endings are cut
- Injury to a muscle nerve, leading to muscle weakness
- Itching
- Keloid (an enlarged scar) formation
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What is the cost of Mohs Surgery in India?
The total cost of Mohs surgery in India can range from around INR 60,000 to INR 2,00,000. However, many prominent hospital doctors in India specialize in Mohs surgery. But the cost varies across different hospitals.
If you are coming from abroad, apart from the cost of Mohs surgery, there will be an additional cost of living in a hotel and the cost of local travel. After the procedure, the patient is kept for one day in the hospital and seven days in the hotel for recovery. So, the total cost of Mohs surgery in India comes to a total of INR 75,000 to INR 2,60,000.
We hope that we could answer all your questions regarding Mohs surgery through this article.
If you need more information about Mohs surgery, you can contact a Dermatologist.
We only aim to provide you with information through this article. We do not recommend any medication or treatment to anyone. Only a qualified doctor can give you the best advice and correct treatment plan.
