Eights steps to perform Mohs surgery in Westlake Village, CA
Mohs surgery is considered the gold standard among procedures to remove skin cancer. Dr. Daphne Panagotacos (Daphne I. Panagotacos, M.D. Skin Care Centre) is an experienced provider of Mohs surgery in Westlake Village, CA for suitable candidates. The Mohs surgery procedure can be explained in eight basic steps as follows:
- You can wear the hospital gown or your regular clothes depending on the position of the skin cancer. The Mohs surgeon then observes the place where you had the biopsy and might place a mark on it with a pen for reference purpose. The doctor will then decide on your position (sitting up or lying down) for better access to the spot.
A surgical drape is used to cover the area. If the spot is on your face, then you may not be able to see what is going on. The doctor will keep talking to you through the process. The surgeon injects a local anesthesia which helps in numbing the area entirely. You can stay awake during the procedure.
- The surgeon removes a thin layer of the cancerous tissue that is visible. Some skin cancers have roots or extensions that are not seen from the surface which means they are like the tip of the iceberg. The doctor examines the tissue to confirm that more cancerous cells are present. A bandage is used to cover the wound temporarily while you relax, and the lab work goes on.
- The Mohs surgeon makes cuts into the tissue, codes them with color dyes and then draws a map of the site of the surgery. The tissue that is divided is frozen. Then it is cut into thin slices which are horizontal. These slices are then kept under a microscope, stained, and covered. This process requires a lot of care and time to complete.
- With the help of a microscope, the physician examines the underside and the edges of the tissue to check if there are any remains of cancer cells. If yes, then they mark the location on the map. The surgeon will let you know if they will remove another layer of the tissue.
- Once the surgeon decides that another layer of tissue needs to be removed, they may inject local anesthesia again if required and remove the layer carefully. Then the lab work starts once more, and this process is repeated until no cancer cells remain.
- Once the surgeon determines that the spot has no cancer cells, they will close the wound with stitches or leave it open to heal, depending on the location and size of the wound. In few cases, the wound may require reconstruction with a flap of skin, where adjoining tissue is placed over the wound or even a possible skin graft.
There are some cases in which the physician will arrange to repair the wound with a specialist like a plastic surgeon. However, in most cases, the Mohs surgeon would repair the wound immediately after getting the clear margins.
- Be prepared to spend quite a few hours at the doctor’s office, if there are more than two rounds of the process needed. It is worth the wait, as this accurate technique has been proven to have the highest cure rate of any skin cancer treatment. In turn, this will save you from a lot of health issues with only a small scar visible. You must strictly follow the instructions given by the doctor for care of the wound, and the follow-up routine for best results.
- After removing the cancerous tissues, the doctor will discuss in detail about the options for healing the wound. Some of the options are:
- Closing the wound with stitches
- Let the opening heal by itself
- Skin flap can be used to cover the wound
- Skin graft can be taken from another area to cover the wound
- The wound can be covered temporarily, and a reconstructive surgery can be planned later
The surgeon knows best once the cancerous tissue is removed. You are sure to go back home with all the skin cancer eliminated. To ensure the recovery is going in the right direction, follow up routine must be followed strictly.
Some of the minor and common issues faced after the surgery are discomfort, swelling, bleeding, and redness. These conditions resolve soon. The procedure for cleaning of the wound and dosage of any medicines to be taken will be discussed by your doctor. The patient should avoid driving while going back home after the surgery as taking sedatives or painkillers may have a drowsy effect on them.