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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Is MOHS Surgery Done For Basal Cell Carcinoma?

Hello. I am a 27-year-old female and I have recently been diagnosed with basal cell carcinoma. The cancer began about a year and a half ago on the bridge of my nose (at least that is about how long ago I remember noticing it). I am scared to death of the Mohs Surgery I am scheduling. I have a history of cystic acne, and the obvious scars on my back and face have severely lowered my self-esteem. I feel that the possible extreme scarring of this surgery will make me feel worse. Can you please provide me with more information on this surgery? Also, I feel like I am too young to be going through this. My dad had Mohs Surgery from basal cell years back, from a bump he had on his cheek for 5-6 years. They cut a huge hole out of his face and there is still a noticeable scar. I am scared to death.
Mon, 6 Apr 2015
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Dermatologist,  's  Response
Mohs surgery is a method of tumor removal and evaluation under the microscope to ensure that skin cancer is removed. It has the highest rate of cure for the most common forms of skin cancer, Basal cell carcinoma and squamous cell carcinoma. First, the tumor is marked with a pen to delineate the visible margins. Then, the area is numbed using tiny needles. This process only takes a few minutes. The area is prepped to remove bacteria. The cancer is removed using a scalpel along with a very narrow margin of skin that appears to be un-involved. The removed skin is mapped and inked so that if there is cancer at the margins, the doctor knows where the cancer is on the patient. The removed skin is processed, cut, put on glass slides, and stained. The doctor looks at the slides to ensure that the cancer is removed completely. If not, the doctor goes back and takes a piece of skin from the patient where the cancer is. This piece will be tested just as the first was.

Of all the available treatments, Mohs' surgery is the most effective and removes very little normal (or uninvolved) skin. But, if a tumor is one-inch in diameter, a piece must be removed that is slightly larger than that.

The final cosmetic appearance after surgery depends upon the reconstruction that occurs after the Mohs' procedure.
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How Is MOHS Surgery Done For Basal Cell Carcinoma?

Mohs surgery is a method of tumor removal and evaluation under the microscope to ensure that skin cancer is removed. It has the highest rate of cure for the most common forms of skin cancer, Basal cell carcinoma and squamous cell carcinoma. First, the tumor is marked with a pen to delineate the visible margins. Then, the area is numbed using tiny needles. This process only takes a few minutes. The area is prepped to remove bacteria. The cancer is removed using a scalpel along with a very narrow margin of skin that appears to be un-involved. The removed skin is mapped and inked so that if there is cancer at the margins, the doctor knows where the cancer is on the patient. The removed skin is processed, cut, put on glass slides, and stained. The doctor looks at the slides to ensure that the cancer is removed completely. If not, the doctor goes back and takes a piece of skin from the patient where the cancer is. This piece will be tested just as the first was. Of all the available treatments, Mohs surgery is the most effective and removes very little normal (or uninvolved) skin. But, if a tumor is one-inch in diameter, a piece must be removed that is slightly larger than that. The final cosmetic appearance after surgery depends upon the reconstruction that occurs after the Mohs procedure.