Mohs Surgery

Mohs Surgery is a method of removing skin cancer in stages and evaluating the margins of the cancer lesion to be as sure as we can that it is fully removed. We call our method "Modified Mohs Analysis" because our pathologist uses a slightly different technique than traditional Mohs surgery to analyze the skin cancer lesion. During the surgery, the skin cancer lesion is frozen and a pathologist looks at the specimen to determine if the cancer is completely removed. If there is any remaining skin cancer in the edges of the specimen, that specific area is removed and a pathologist evaluates it again until all of the margins are clear.

Modified Mohs Analysis can be performed for skin cancers including Squamous Cell Carcinoma and Basal Cell Carcinoma, but other types of lesions may not be able to be frozen so cannot be removed using this method.

What If I Have Melanoma?

After The Cancer is Removed

Dr. Holcombe's expertise is minimizing scars

The first goal of surgery is to remove the cancer completely. After that is accomplished, we will evaluate the wound and the best way to repair it. You will have a scar after surgery to remove skin cancer, but we will work hard to minimize the scar and repair the wound in a way that encourages healing.

There are different ways of repairing wounds, and the best option will depend on the size and location of the wound. Dr. Holcombe may use primary repair, closing the wound in a straight line, or he may need to create a skin flap to reduce tension for larger wounds. If he cannot use either of those methods, he will use a skin graft to close the wound.

Preparing For Surgery

Surgery Location

Modified Mohs Analysis is performed at St. Joseph Outpatient Surgery Center because this allows us to work with the pathologist to evaluate skin specimens. If you have high risk medical conditions, it may need to be done at St. Joseph Hospital. We will let you know the location of your surgery on the day of your consultation.

Checking In

Please be prepared to check into the surgery location at least one hour before your scheduled surgery time. While most of these procedures are done under local anesthesia (meaning, you'll be awake), you will change into a hospital gown and have the procedure in an operating room. This allows us to have all of the resources necessary to evaluate your cancer and close your wound in the best possible way.

Eating and Drinking

If your surgery is done while you are awake, you can eat and drink normally on the day of your surgery.

If you choose to have your surgery under general anesthesia, you will need to be fasting for at least 8 hours prior to the surgery. You will receive specific instructions prior to the surgery.

Medications

Most medications can be continued normally prior to surgery to remove skin cancer. Please make sure that we have an updated list of your medications during your consultation so that we can give instructions for any medications that may need to be stopped.

After Surgery

We will give you specific post-operative instructions following your surgery, and you can also review our post-op instructions by following the link below.

Some things to expect:

We will ask you to avoid exercise for at least one week following surgery to allow for optimal blood flow and minimal swelling to the wound. We do not want you doing any activities that could stress the wound as it is in the early stages of healing.
You will need to do some wound care following surgery, and we will give you instructions to guide you.
We will see you for follow up at 1-2 weeks post-op to check your wounds and remove any sutures. A specific date will be given to you on the day of surgery.
If you need surgery on the lower extremities: please be prepared that you will need to elevate your leg for 1-2 weeks following surgery. This is most important for skin graft repairs, where you will need to arrange for support the week after surgery as you will be resting and elevating your leg.

Post-Operative Instructions

What is Mohs Surgery?