Mohs Surgery

The biopsy is a diagnostic procedure, and not a treatment for skin cancer. While&nbsp;some pathologists will comment on the type of basal cell seen, regardless of the type, further treatment with Mohs surgery is important to make sure that the deep and peripheral margins are clear of tumor. While it may seem like the site is healing well and the cancer is gone, it is impossible to know for sure without further work.&nbsp;Fortunately Mohs surgery can evaluate the margins microscopically, give you the highest cure rate and smallest scar possible.

I have had a large reddish limp with blood vessels showing around it for over 3 yrs. Had some type of biopsy done. A lot of pus came out and the pathology report came back stating they found invasive basel cell cancer. My cheek is healing nicely now. Nothing shows on my face now, but a hole and I am wondering if the report can tell how deep the cancer is and should I have another biopsy to see if the cancer is gone scheduled for Mohs in 3 weeks. Do not want to do the procedure if the cancer is gone.

No sign of basel cell cancer after biopsy. Would the pathology repot be able to tell how deep it is?

You appear to be healing well, however the flap is a little thick with some pin cushioning. This can be fixed easily with a steroid injection or dermabrasion. I would follow up with whomever did your Mohs surgery/reconstruction to show them and possible treatment.

I had a basal cell taken from the right tip of my nose and the dermatological surgeon who performed it did a local flap taken from the nose itself. Its been 7 weeks and the end of my nose appears to have a foldover effect where the flat is not really joined with the rest of the nose correctly in my opinion. Should I have a plastic surgeon look at it?

Should a nose flap after Mohs surgery look fairly normal after 7 weeks? (Photo)

I tell my patients that anytime we cut the skin, it will leave a scar. Whether that scar is noticeable to most people will depend on the type of biopsy taken (shave vs punch biopsy) and how deep the biopsy needs to be. Lesions concerning for skin cancers such as melanoma will need to be deeper than other biopsies and may leave a more noticeable scar.

Will a biopsy of a small lesion on the nose always leave a scar?

Skin flaps are very common on the nose given the relatively tight skin here, even with small defects. Looser skin on the cheek or in between the eyebrows/upper nose will often be used as a flap to close defects on the nose. While initially it may appear to be quite a long or funny looking scar, these flaps heal very well. A fellowship-trained Mohs surgeon or Plastic Surgeon will be very familiar with these common flaps, and this will likely yield a more favorable cosmetic result compared to leaving it open to heal. Best of luck. Dr. Mina

Melanomas on dor sum needs to be excised. MOHs Dr say with 8mm margins, then goes to pathology , which will determine next steps. Dr says he's not a plastic surgeon. He can close. Or I could let heal on its own. Or use plastic surgeon to make flap. Inclined to do the latter. Where should the flap tissue come from? All input greatly appreciated

Nose reconstruction after melanoma removal?

Wound healing after Mohs surgery can be quite variable depending on the location, size of the defect, and type of repair. Typically, my younger patients are anxious to return to their jobs the next day which is appropriate in most cases; however, I let them know that they will have a fair amount of swelling/bruising and will need to wear a bandage for at least a week. The majority of swelling does subside significantly within the first week after surgery. A pre-operative consult with your Mohs surgeon can give you a better idea of the type of recovery, scar and healing you can expect for your individual skin cancer and treatment.

What is the typical recovery and downtime from Mohs surgery? What should I expect for after care needs?

What is the typical recovery and downtime from Mohs surgery? What should I expect for after care needs?

Mary Alice Mina, MD

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