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What is Mohs Surgery?

Mohs surgery is a meticulous procedure that relies on the accuracy of the microscope, instead of the human eye, to help ensure that all cancer cells are removed when a skin cancer is treated.

Dr. Frederic E. Mohs pioneered the surgery at the University of Wisconsin in the 1930's. Mohs surgery requires the specialized skill and training of a Mohs surgeon who acts as a surgeon, pathologist and reconstructive surgeon. Dr. David Appert, a board-certified dermatologist and dermatologic surgeon, performs Mohs surgery at the Mid Dakota Dermatologic Surgery, Cosmetic & Laser Center located in Gateway Mall.

Initially, Dr. Appert functions as a surgeon to remove the visible tumor and a small margin of healthy tissue. Then he meticulously "maps" the removed tissue and divides it into smaller sections to be examined under the microscope for remaining cancer cells. Dr. Appert then works as a pathologist and examines the tissue under the microscope. With the Mohs procedure, Dr. Appert can examine 100% of the tissue that surrounds the tumor. This results in a skin cancer cure rate of 97-99%. Other pathology techniques typically examine only a small portion of the tissue margin. Finally, Dr. Appert functions as a reconstructive surgeon in repairing the wound left by the surgery. Dr. Appert makes every effort to preserve cosmetic appearance and minimize scarring. Dr. Appert will help you choose the reconstruction technique that is best for you.

When is Mohs Surgery Used?

Mohs surgery is usually recommended for skin cancers that occur in sensitive areas of the body or that have a high likelihood of recurrence. These include skin cancers that:
  • Are located in cosmetically or functionally important areas such as around the face, scalp and neck. Mohs surgery can be used on other body areas, when tissue conservation is important, and for skin tumors that have a high risk of recurring.
  • Have cells that grow rapidly or deeply
  • Have recurred after previous treatment
After a suspicious area of the skin has been identified, the first step in diagnosing a skin cancer is a procedure called a biopsy. During the biopsy, your physician removes a sample of the affected skin. This tissue sample is then examined under a microscope to see if any cancer cells are present.

If the biopsy is "positive", this means cancer cells are present and you have a skin cancer. At this point, your physician may recommend Mohs surgery.

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