Piedmont Plastic Surgery and Dermatology

Mohs Micrographic Surgery (MMS) is a specialized surgical procedure used for removal of certain types of skin cancer.  It remains the “gold standard” for surgical treatment of primarily basal cell and squamous cell carcinoma skin cancers on the head and neck, as well as other sites on the body when certain specific criteria are met.  MMS is designed to remove 100% of the skin cancer while sparing as much of the normal skin as possible.  This results in the smallest opening in the skin, therefore allowing for the smallest scar after the skin is repaired.

Dr. Frederic Mohs invented the procedure with the primary concept being the removal of a skin cancer in layers, one small piece at a time.  The patient waits 30-45 minutes after each layer has been removed, for the Mohs surgeon to evaluate the slides under a microscope.  This is done to see if there are any residual tumor roots that remain in the patient’s skin.  As the cancer tissue is removed it is mapped to maintain the original tissue orientation.  This allows for any additional pieces of cancer tissue to be accurately located and removed without having to cut around the entire area again.  The average number of layers is approximately two, with the total visit lasting one to four hours.  The size and the extent of the final opening, as well as the total visit time, remain unpredictable due to the unknown location of the skin cancer roots.

Mohs surgeons are not only trained to remove the tumor by using the Mohs method, they are also trained to perform the necessary cosmetic reconstruction of the tumor opening after the skin cancer has been fully removed.  In certain circumstances, for example; maintaining continuity of care from a referring surgeon, or the need for an extensive reconstruction from an aggressive tumor in a difficult location, the use of one of our plastic surgeons may also be enlisted.  

Dr. Charles Johnson is our Mohs surgeon.  He has performed over 5,000 Mohs cases since completing his residency training in 2001.  If you currently have a biopsy proven skin cancer on the head and neck or a large and/or recurrent skin cancer in another location on the body, please do not hesitate to call for a consultation with Dr. Johnson to see if Mohs Micrographic Surgery is indicated for your cancer.  The procedure, when indicated, is covered by your insurance carrier.