Mohs Surgery Specialist

What is Mohs (also called Mohs micrographic surgery)?

Mohs surgery is a special technique used to remove skin cancers on certain parts of the body – without having to go to sleep.  Using sensitive equipment, cancers are meticulously removed one layer at a time during Mohs surgery until all the skin margins are clear.

Mohs, named after Dr. Fred Mohs who pioneered the early technique in the 1970s, means smaller scars and lower recurrence rates for many skin cancers.

During Mohs, your treating doctor acts as both pathologist and surgeon, which means Mohs is the most comprehensive, safe, and accurate way to treat cancers in high-risk areas.

Mohs surgery has two main advantages:

1. Mohs has a very high cure rate
2. Mohs allow us to preserve as much healthy skin as possible

Who performs Mohs surgery at Knight Dermatology?

Dr. J. Matthew Knight, Dr. Alexander Daoud, and Dr. Paul Graham perform Mohs surgery at Knight Dermatology. Patients will report to either the Lake Mary or Winter Park Knight Dermatology location for their Mohs surgery.

What is it like to have Mohs surgery?

During Mohs surgery, you remain awake and alert. This means Mohs can be safely performed in our offices without having to go to the hospital or an operating room.

On the day of your surgery, Dr. Knight, Dr. Daoud, or Dr. Graham, will first examine the area to be treated and talk with you about the plan for your care.  Once all your questions are answered, the Mohs team will prep you for the first stage of Mohs:  removal of your skin cancer. This includes giving you an injection of local anesthetic. After the 1^st excision is performed (the 1^st “layer” or “stage”) you’ll be bandaged so that you can wait comfortably.  You’ll be free to wait in our Mohs waiting room, read, watch movies, check e-mail, or whatever you desire.

While you wait, the Mohs team will be preparing the excised tissue, placing it on glass slides, and delivering it to Dr. Knight, Dr. Daoud, or Dr. Graham so they can look at your tissue under a very sensitive microscope.

If cancer cells are found, you’ll need another layer of skin removed.  This process of removing a thin layer of skin and looking at it under a microscope continues until the surgeon no longer sees cancer cells.

Once cancer cells are no longer seen with the Mohs technique, Dr. Knight, Dr. Daoud, or Dr. Graham will speak with you about how to repair your wound.  Some wounds heal nicely without doing anything further. Most require stitches. Some wounds are larger and require advanced repairs like skin flaps or grafts. 

Rest assured, Dr. Knight, Dr. Daoud, and Dr. Graham have extensive training in all types of wound repairs, and will work with you to achieve the best possible scar after your Mohs procedure.

When is Mohs surgery recommended?

Mohs is appropriate for skin cancers that:

• Grow in areas of the body with little tissue to work with (e.g. face, ears, scalp, neck, hands, shins, feet, genitals)
• Are aggressive or large
• Have recurred after previous treatment

Mohs is not required for all skin cancers. Most insurances will not pay for Mohs in lower-risk areas of the body like the trunk or arms.

Can Mohs treat melanoma?

Melanoma, the most serious and life-threatening skin cancer, is treated differently than basal and squamous cell cancer.  Mohs is occasionally recommended for certain early types of melanoma.

When treating melanoma, then we use a modified type of Mohs surgery called slow Mohs. It’s called slow because it’s not possible for the surgeon to look at the removed skin and know right away whether it contains cancer cells. More time is needed.

If you have slow Mohs, your surgeon will remove the visible skin cancer and a bit of normal-looking skin around it. You’ll then be bandaged and sent home.

Most patients return the next day. It’s then that the patient learns whether more skin must be removed or the wound can be closed. Again, some wounds are left to heal on their own.

Mohs Q & A ➡