Advantages of Mohs Micrographic Surgery

• Highest cure rate available for skin cancer
• Visualizes 100% of margin of excision vs. 1% with normal pathology
• Smallest amount of normal skin is removed
• Preserves cosmetics and function of treated area
• Smallest possible defect results in smallest possible scar
• Surgery and microscopic examination by the same person
• Reconstruction performed immediately after tumor removed
• All done under local anesthesia in the office

Introduction

In the 21st Century, Mohs Micrographic Surgery represents the state-of-the-art treatment for skin cancer by providing the highest cure rate, minimal sacrifice of normal skin, and smallest possible scar. The origin of Mohs Micrographic Surgery dates back to the 1930's when Dr. Frederick Mohs at The University of Wisconsin was researching a way to remove complicated skin cancers unresponsive to traditional therapies such as standard excisional surgery, cryosurgery (freezing), electrodessication and curettage (scraping and burning), and radiation therapy. Mohs Micrographic Surgery is Dr. Khrom’s treatment of choice for complicated skin cancers including basal cell carcinoma, squamous cell carcinoma, and others that have one or more of these characteristics:

• Located on the face, ear, eyelid, lip, and scalp
• Poorly demarcated (unable to determine edges of the tumor with the naked eye)
• Recurrent (failed prior treatment)
• Incompletely removed (positive margins after initial removal)
• Large (over 2 cm in diameter)
• Aggressive histologic features (morpheaform, perineural invasion, poorly differentiated)

Pre Surgery	1 Year After Surgery

Pre Surgery	After Surgery	6 Months After Surgery

Pre Surgery	Defect	After Surgery	6 Months After Surgery

Pre Surgery	Defect	After Surgery

For decades, Mohs micrographic surgery has proven effective in getting to the roots of skin cancer by combining the surgical removal of cancer with the immediate microscopic examination of the tumor and underlying diseased tissue. This process allows dermatologists who are trained in Mohs surgery to see beyond the visible disease and precisely identify and remove the entire tumor and nothing but the tumor.

Dr. Khrom is one of a handful of fellowship-trained Mohs surgeons in Brooklyn with a special interest in reconstructive techniques.

The procedure is performed on an outpatient basis, under local anesthesia. The healing process is similar to that of most surgical procedures. This technique ensures that all the diseased tissue and only the diseased tissue is removed, thereby minimizing the size of the wound and the cosmetic result.

When the final stage of Mohs Micrographic Surgery is found to be free of tumor, your skin cancer has been removed with a 99% cure rate for primary tumors and over 95% for recurrent tumors (previously treated but then came back). You are left with a skin defect that has clean margins (free of skin cancer). The Mohs Micrographic Surgery phase of your procedure is completed.

The next phase of your procedure is the skin reconstruction. The reconstruction phase is where Mohs surgeons and other reconstructive surgeons can differ significantly in their approach and final results. Dr. Khrom is an expert at skin reconstruction, especially of the nose, ears, lips, and facial defects, and will utilize highly advanced reconstruction techniques to provide a natural cosmetic result with minimal to no visible scarring.