The treatment of choice for cancers of the face and other sensitive areas, the MOHS technique allows the physician to precisely identify and remove the entire tumor, leaving surrounding healthy tissue intact and unharmed.
First, the surgeon will excise the tumor. The specimen will then be immediately prepared and examined by the surgeon, who is also our in-house pathologist. The specimen will have been specially marked so that if the cancer has not been entirely removed, the surgeon can then immediately return to the site and remove only what is absolutely necessary, leaving as little scarring as possible. Because our MOHS specialists are at the height of their field in surgery, pathology, and re-construction, this procedure has the highest success rate of all treatments for skin cancer.
Here is an example of the step by step process used to determine whether a patient is a candidate for MOHS surgery
Initially, a suspicious lesion or mole will be viewed by the dermatologist with the naked eye, then examined with a dermatoscope.
The lesion will then be subjected to laser skin imaging with a confocal microscope. When used appropriately by an expert confocalist, this technology can spare a patient from an unnecessary biopsy or, in some cases, can diagnose melanoma/skin cancer which would not have been detected by the naked eye alone.
After confocal microscopy and analysis, if the lesion is still classified as suspicious, the physician will perform a skin biopsy, which is still the gold standard for diagnosing benign from malignant lesions. We always have a board certified dermatopathologist on-site to review these biopsies and correlate with the clinical impression, thus managing the patient in the most effective possible way.
Sometimes, other skin growths, such as age spots or dark skin tags, can be mistaken for moles. At Rao Dermatology, we combine over 25 years of clinical experience and judgement with the latest non-invasive diagnostic tools to determine whether a biopsy is necessary. This is especially important if you have numerous moles or a mole at a cosmetically significant site, in order to minimize the possibility of scarring. If your dermatologist is unconvinced that a mole is benign, it will still be biopsied, but at Rao Dermatology, we use every technological means necessary to determine whether surgery is the only option.
When surgery is necessary, or when a patient chooses to remove a mole for aesthetic purposes, we perform these procedures in-house in the privacy and comfort of our state-of-the-art surgical facility.
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