Mohs Surgery & Surgical Services

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Our Surgical Services:
  • Our goal at Affiliated Dermatology has always been to provide the most comprehensive system of Dermatologic care possible. 
  • Offering a full suite of surgical services is part of that goal.  
  • While referrals to trusted colleagues are occasionally necessary, we prefer to handle most of our patient’s surgical needs within our group.  
  • In addition to offering Mohs surgery for patients, we also maintain a JCAHO-accredited surgical facility on-site in Dublin where many of our patients will undergo surgery for larger tumors such as melanoma.   
  • This is also where we prefer to handle the cosmetic reconstruction of their Mohs defect sites camouflaging these defects into the natural skin tension lines.
  • Our surgical model ensures that patients have the benefit of a very experienced and caring medical team fully dedicated to their treatment.    
  • We feel this additional layer of surgical refinement sets us apart as a leader in our specialty. 

Is surgery right for me?
  • “Skin cancer” is a very broad term.  
  • For instance, Melanoma is a skin cancer that when treated early with local surgery can be cured.  In advanced stages though it may require additional surgery, chemotherapy, radiation, or immunotherapy.  
  • Basal cell carcinoma on the other hand, which happens to nearly one of every five individuals only rarely requires anything beyond localized treatment.  
  • On receiving a skin cancer diagnosis you can be assured that your provider will thoroughly weigh all of your treatment options.  
  • We review the type of cancer, the location, past treatments, and your overall health and wellness when planning an approach to your skin cancer. 
  • Complicated cases are discussed as a group and the best options are presented.  
  • Alternatives to surgery are considered such as radiation, local destruction, and topical chemotherapy.
  • Finally, we will bring that recommendation back to you for your input before we ultimately decide on the best course of treatment.     ​​
What is Mohs Surgery?
  • Named for its creator, Frederic E. Mohs, this highly refined surgical technique allows for microscopic control of surgical margins.   
  • Specially trained dermatologists use it to treat both common and rare types of skin cancer that often have high rates of recurrence by traditional surgery.  
  • The Mohs surgical technique provides patients with the highest possible cure rate for their skin cancer (>99%) while creating the smallest surgical defect.  
  • Mohs is an outpatient procedure, avoiding the hassles of the overburdened and understaffed hospital system.
  • Mohs is especially useful on cosmetically sensitive areas like the head and neck, as well as those areas where large defects could be extremely difficult to close, such as the hands or feet.
  • On-site pathology unique to the Mohs technique allows the surgeon to track the tumor and minimize the removal of normal skin.   
  • Mohs is a very effective “tool” in our armamentarium to cure patients of their often difficult-to-treat skin cancer.  

What to expect on Mohs surgery day?
  • Patients present to the office on the day of their procedure without the need for fasting periods or stoppage of medication as the entire procedure can be performed with just local anesthesia.  
  • After the nurse gets you checked in, answers all your questions, and makes you comfortable for the procedure, the area is gently anesthetized so that you have no pain for the procedure.  
  • The Mohs surgeon then carefully begins the surgery by removing the skin cancer with a very small clinical margin.
  • After each layer is removed, the surgeon examines it under a microscope to see if any cancer cells are present. 
  • If cancer cells are found, the surgeon removes another layer of skin, but only in the location of the persistent tumor cells.  
  • This process is repeated until all of the cancer cells have been removed and the cancer is considered to be “cured”.
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