Mohs surgery is a specialized type of surgery developed by Dr. Frederic Mohs in the early 1940s. Dr. Mohs recognized that a skin cancer often resembles a “tip of the iceberg” with more skin cancer cells growing downward and outward into the skin, like the roots of a tree. These “roots” are not visible with the naked eye, but can be seen under a microscope. Mohs Micrographic Surgery is a highly specialized and precise treatment for skin cancer in which the cancer is removed in stages, one tissue layer at a time. It is an outpatient procedure. This insures the highest rate of cure with the smallest amount of tissue removed. Dr. Mohiba Tareen, who completed a year-long procedural dermatology fellowship AFTER her 3 year dermatology residency at Columbia University, has specialized training in Mohs surgery.
What Is It?
Mohs surgery is a highly effective way of removing skin cancers. Once a tissue layer is removed, the edges are marked with specially colored dyes, and a map of the specimen is created.
The tissue is then processed and carefully examined under the microscope so that any microscopic roots of the cancer can be precisely identified and mapped.
When cancer cells are seen, an additional tissue layer is removed only in areas where the cancer is still present, leaving normal skin intact. This saves as much normal, healthy skin as possible – so this is an excellent option for skin cancers on the face. Once the cancer has been removed, options for repair of the wound, include natural healing (granulation), stitching the wound together by a side-to-side closure, or using a skin flap or graft.
Watch here as Dr. Mohiba Tareen and Hannah Dahl, PA-C discuss Mohs Surgery.
How does Mohs surgery work?
Once a tissue layer is removed, the edges are marked with specially colored dyes, creating a map of the specimen. The tissue is then processed and carefully examined under the microscope so that any microscopic roots of the cancer can be precisely identified and mapped. When cancer cells are seen, an additional tissue layer is removed only in areas where the cancer is still present, leaving normal skin intact. This saves as much normal, healthy skin as possible. Once the cancer has been removed, the Mohs surgeon will explain options for repair of the wound, including natural healing (granulation), stitching the wound together by a side-to-side closure, or using a skin flap or graft. For very deep or large tumors that may require repair in the operating room or patient may be referred to a plastic surgeon. We have an in-house plastic surgeon, Dr. Matthew Camp on staff to help serve our patients with these needs.
Yesterday was my first time visiting Tareen. It was an amazing friendly experience the minute you walk in the door. Kelsey Strub was great to work with! Highly recommend her work and patient care along with the rest of the staff that played a part in my experience.
Dr. Tareen and her staff are amazing and truly care about me as a patient. I have a personal history and family history of melanoma and I know I am in great hands with Dr. Tareen or any of the staff she hires. I send all of my family and friends to Tareen Dermatology because I trust them implicitly. Thank you Dr. Tareen and team!
The beauty of this facility goes beyond it’s physical appearance. The professionalism, compassion and care of the staff is hard to put into words. This was my first time receiving filler in my lips. The entire process was painless and the results were immediate. They comforted me and explained each step thoroughly. Dr. Tareen and her staff are the best! Her caring nature and desire for perfection is shown in my results. She turned my frown upside down!! I am extremely pleased with the results!
Best dermatologist office, if not best medical office, I’ve ever been to. The doctors here actually want to help you. It’s also so fast and easy to make an appointment, not like other dermatology offices where you have to schedule a visit 6-8 months in advance. The doctors are so knowledgeable and willing to work with you instead of brush off your feelings and requests. So happy I happened to be referred here. It’s great.
Not all skin cancer requires Mohs surgery. Criteria for Mohs are stringent and include the following:
- The skin cancer is in an area where it is important to preserve healthy tissue for maximum functional and cosmetic result, such as eyelids, nose, ears, lips, other critical facial areas, as well as fingers, toes and genitals
- The skin cancer was treated previously and has come back
- Scar tissue exists in the area of the skin cancer
- The skin cancer is large
- The edges of the skin cancer cannot be clearly defined
- The skin cancer is growing rapidly or uncontrollably
The skin cancer is of an aggressive subtype