The North Shore-LIJ Mohs Skin Cancer Center specializes in the diagnosis, treatment and prevention of skin cancer, providing the most advanced treatments and highest quality of care, delivered with heartfelt compassion.

Under the leadership of Dr. Jeffrey Ellis, The North Shore-LIJ Mohs Skin Cancer Center provides a full range of therapies for the treatment of skin cancer including excision (surgical removal), curettage and electrodessication (scraping and burning), X-ray therapy, cryosurgery (freezing), topical chemotherapy and Mohs micrographic surgery. The method chosen depends on the location of the cancer, its size, type and previous treatments

What is Mohs Micrographic Surgery?

Mohs micrographic surgery is a highly specialized, advanced surgical technique that offers the highest possible cure rate for many skin cancers and preserves the greatest amount of normal tissue as possible. If surgical repair of the defect is necessary, it can be done with the knowledge that there is no residual tumor left. As a result, Mohs micrographic surgery is very useful for large tumors, tumors with indistinct borders, tumors near vital functional or cosmetic structures and tumors for which other forms of therapy have failed.

How is the Surgery Performed?

Mohs micrographic surgery is performed in a procedure room under sterile conditions with local anesthesia. Once anesthesia is complete, the visible portion of the tumor is removed by excision or scraping with a sharp instrument called a curette. Following the removal of most of the tumor, a thin layer, encompassing the complete undersurface of the tumor, is excised.  That layer is then cut into small pieces and a map is drawn to identify the location of each piece. The edges of each piece are marked with dyes to aid in orientation on our map. Each piece is then frozen and these slices are cut, stained and examined under the microscope. Any areas in which the tumor is found are marked on the map.  Regions with remaining tumor tissue are then re-excised. This procedure is repeated until the entire tumor is excised and the cancer is removed. After each layer of tissue is obtained, bleeding vessels are cauterized or ligated with a suture.  A pressure dressing is applied.

How Long Does it Take?

It takes 15 to 30 minutes to remove each layer of tissue and one or two hours to process and examine it. Most tumors require the removal of one or two layers, but depending on the extent of the tumor, it is not uncommon to need three or more layers. Extensive tumors may need more surgery and may require a second visit, but this is a rare occurrence.

Will Mohs Micrographic Surgery Cure Me?

If you have a basal cell carcinoma, there is about a 99% chance that you will be cured.  If you have a squamous cell skin cancer, you can be about 95% certain you will be cured.  However, follow-up visits to detect the rare recurrence are very important. After the initial postoperative period, you will return to your referring physician for routine skin care and tumor surveillance.