When is Mohs Surgery Indicated?
Mohs surgery is useful in treating basal cell carcinomas and squamous cell carcinomas. When these cancers are located on the nose or ears or around the eyes, this is the treatment of choice. Mohs may also be indicated for very large skin cancers, skin cancers that are long standing, or that have returned after previous treatment.
How is Mohs Performed?
Mohs surgery is performed in an office setting using local anesthetic. After the removal of the visible portion of the tumor, by excision or curettage (debulking), there are two basic steps to each Mohs Micrographic Surgery stage. First, a thin layer of tissue is surgically excised from the base of the site. Next, this tissue is processed in a unique manner and examined underneath the microscope. On the microscopic slides, Dr. Retief examines the entire bottom surface and outside edges of the tissue. This tissue has been marked to orient top to bottom and left to right. If any tumor is seen during the microscopic examination, its location is established, and a thin layer of additional tissue is excised from the involved area. The microscopic examination is then repeated. The entire process is repeated until no tumor is found.
How is the Wound Treated?
After the skin cancer has been completely removed, a decision is made on the best method for treating the wound created by the surgery. These methods include letting the wound heal by itself, closing the wound in a side to side fashion with stitches, closing the wound with a skin graft or a flap. In most cases, the best method is determined on an individual basis after the final defect is known. We individualize your treatment to achieve the best cosmetic results and the least amount of scarring possible. Dr. Retief’s unique qualifications as a dermatologist and a surgeon provide the patient with excellent results. To view pictures of Dr. Retief’s actual patients, please view our gallery.
What are the Advantages of Mohs Surgery?
Mohs Micrographic Surgery allows for the selective removal of the skin cancer with the preservation of as much of the surrounding normal tissue as is possible. Because of this complete systemic microscopic search for the “roots” of the skin cancer, Mohs Micrographic Surgery offers the highest chance for complete removal of the cancer while sparing the normal tissue. The cure rate for new skin cancers exceeds 97%.
Who performs Mohs Surgery?
Only dermatologists perform Mohs surgery. Some of these dermatologists have completed fellowships in Mohs surgery while many others are trained in the procedure from colleagues experienced in the procedure. Dr. Retief completed her fellowship in 1999 at The Medical University of South Carolina (MUSC) in Charleston. During this intensive surgical fellowship, Dr. Retief performed over 1,000 Mohs Surgery and Reconstructive cases in addition to hundreds of Cosmetic surgery and Laser cases. Dr. Retief is one of the few fellowship trained Mohs Surgeons in Nashville, TN and the only dermatologist with surgical priveleges at Centennial Hospital