What is Mohs Surgery?
Mohs surgery is a micrographic surgery that effectively removes cancerous skin cells while sparing healthy cells. The surgery targets and removes the two most common types of skin cancer cells — basal cell carcinomas and squamous cell carcinomas. Mohs surgery is the golden standard for removing nonmelanoma skin cells around areas with important functionality.
Most surgeons prefer Mohs surgery to other micrographic approaches. Why? It requires meticulous examination of the skin lesions. The iterative procedure operates in targeted stages to ensure the removal of 99 percent of cancerous skin cells. In the case of eyelid skin cancer where the eyelids are thin and have less tissue than normal, Moh’s surgery is particularly recommended.
A multifaceted approach delivers the best results. First, a skilled Mohs surgeon performs Mohs surgery to examine and remove the cancerous tissue. Then in conjunction, an experienced oculoplastic surgeon performs the eyelid reconstruction.
Mohs Surgery – Identifying and Removing the Cancerous Skin Cells
In Mohs surgery, the surgeon applies local anesthesia to the eye area. The patient will be awake but sedated during the procedure. Next, the Mohs surgeon removes a thin layer of the cancerous hypodermis tissue, without removing any unnecessary healthy skin.
After the patient is bandaged, the patient must wait comfortably in the operating room while the examination begins. In the laboratory, the Mohs surgeon divides the tissue and then dyes the sections to make a surgical map of the eyelid. The surgeon freezes the tissue to further divide this frozen skin tissue into even thinner layers.
Next the surgeon examines each layer under a microscope to identify any cancerous skin cells. The surgeon precisely codes the remaining cancerous tissue onto the surgical map to remove any cancerous tissue not visible to the eye upon initial examination. The Mohs surgeon repeats the iterative process until certain that all the cancerous cells have been removed.
Mohs Surgery – Performing Eyelid Reconstructive Surgery
Once the Mohs surgery successfully removes the cancerous skin cells, the oculoplastic surgeon initiates the process of reconstructing the eyelid.
Some patients choose to undergo Mohs surgery without the assistance of an oculoplastic surgeon. However, an Oculoplastic Surgeon limits the need for potential reconstructive surgery and assures patients have better cosmetic results.
With less invasive surgeries, the eye fold defects can be sutured together. This hides visible signs of a scar within the eye creases. For surgeries that require the removal of significant eyelid tissue, more complicated techniques must be used to restore proper eyelid functionality or appearance.
Eyelid reconstruction either requires a reconstructive skin flap (a procedure in which the surgeon transfers adjacent tissue to the surgical area). Or it can require a skin graft (a procedure where reconstruction uses skin from other parts of the face or body). Occasionally, when the cancerous area is too large, the surgeon cannot fully reconstruct the eyelid. Such a case necessitates follow-up reconstructive surgery.
Dr. Taban of Southern California selects and performs the ideal surgery for every surgical scenario. He offers his patients the best functional and cosmetic results. Consult his offices if you are interested in a minimally invasive outpatient surgery that is successful at removing cancerous lesions.
Have a question about Mohs Surgery? Contact us today or visit our FAQ page here.