What is Mohs surgery?
Mohs surgery is a method of removing skin cancer named after and invented by Dr. Frederick Moh, an otolaryngologist at the University of Wisconsin. In Mohs surgery, a map of the skin cancer is created and a layer of skin is removed and evaluated under the microscope while the patient waits. What is unique to Mohs surgery is that the entire surgical margin of the skin layer is evaluated to determine if residual skin cancer is present or if the skin cancer is clear. If the margin is positive, then another layer is taken where it is positive on the map. This process is repeated until the entire skin cancer has been removed. Mohs surgery ensures the margins are clear before surgical closure of the skin cancer site. Closures of the surgical sites are performed by the Mohs surgeon. Typically, the skin cancer removal and the closure are performed on the same day.
Do all skin cancers require Mohs surgery?
No. There is a wide variety of skin cancers and only certain types can be evaluated by the Mohs technique. Basal cell carcinomas and squamous cell carcinomas on the head and neck area are the most common types treated by Mohs surgery. There are other scenarios and skin cancer types that may be treated with Mohs surgery. Criteria that are considered include location, size, skin cancer type, history of previous treatment and comorbidities. Our dermatologists at MDS take all these factors into consideration before recommending Mohs surgery or other skin cancer treatments.
Who performs Mohs surgery?
At MDS, Dr. Lauren Meshkov Bonati performs Mohs surgery for our skin cancer patients. She completed a fellowship in Mohs surgery at Skin Care Physicians in Boston, MA under the tutelage of nationally recognized Mohs surgeons and plastic surgeons. While Mohs surgery was invented by Dr. Frederick Moh who was an otolaryngologist, dermatologists embraced learning, practicing and teaching the Mohs surgery technique. Thus, the majority of Mohs surgeons are dermatologists. Many dermatologists are exposed to Mohs surgery during their residency training. Only a certain number of dermatologists pursue additional training in selective competitive fellowship programs for Mohs surgery. Dr. Bonati is the only fellowship trained Mohs surgeon who resides and practices in the Vail Valley.