MOHS Surgery

Mohs Micrographic Surgery, an advanced treatment procedure for skin cancer, offers the highest potential for recovery —up to 95 percent even if other forms of treatment have failed. This procedure, the most exact and precise method of tumor removal, minimizes the chance of regrowth and lessens the potential for scarring or disfigurement.

Of course, surgical skill and experience are critical to a successful outcome and you can rest assured that you are in excellent hands. Dr. Callahan, a rare fellowship-trained MOHS skin cancer surgeon, supervises all surgical procedures. She has performed over 15,000 MOHS surgeries and is recognized as a “Top Doctor” by US News and World Report.

During the procedure, Dr. Callahan removes thin sections of the skin surrounding the cancerous or precancerous lesion. These are immediately examined under a microscope. (In more common excisional biopsies, the skin is sent to an off-premises lab and results are not available for days). If evidence of cancer is found, another thin section is removed until the margins of the area are free of suspicious cells.

MOHS Consultation

An initial consultation appointment is required before any surgery is performed. During this appointment, Dr. Callahan will review your medical history and all pathology reports, perform a detailed examination of your skin, take photographs and answer any and all questions that you or your family members may have regarding your diagnosis and the planned procedure.

Your MOHS surgery will be scheduled before you leave the office. MOHS surgery appointments are generally scheduled to start in the early morning, allowing the completion of several surgical stages throughout the day (if necessary).

The Day of Surgery

On your surgery day, we ask that you do not make any other appointments.  Due to the detailed nature of the procedure, Mohs can take up the better part of the day.  On occasion, you may need to return to SkinSmart the next day.  You are to eat your normal meals and take all of your normal medications.  You do not need to fast or to discontinue the use of blood thinners unless Dr. Callahan instructs otherwise.

In the office, the surgical site will be inspected once again.  The skin cancer area will be re-identified, photographed, and anesthetized with local anesthetic.  First, the cancer obvious to the naked eye is removed along with a thin layer of skin from around the site.  The tissue specimen is then immediately processed in our on-site Mohs laboratory.  Patients are bandaged and permitted to relax in our private, comfortable MOHS lounge during this process. 

Dr. Callahan will microscopically examine the specimen to identify and map any persistent cancer.  Patients with persistent cancer have the procedure repeated, as required, and another layer is excised until the cancer is completely removed.  The area where the cancer was removed is then repaired using DR Callahan’s unique techniques developed to give the best cosmetic and functional outcome.  Every effort is made to keep our patients comfortable, so repairs will either be on the same day or early the following day.  In some cases, the patient is referred to a plastic or ocular surgeon for final wound repair.  In each case, Dr. Callahan will advise the patient on the best option.

Points to remember:

•  Mohs surgery is a complex procedure, and you could be in our office for several hours, or in some cases, most of the day. 
•  Patients can relax in our comfortable, private MOHS lounge within our SkinSmart Dermatology office
•  Bring a sweater, a good book or Kindle and your laptop computer as we offer Wi-Fi internet service
•  We offer magazines, the Wall Street Journal, US News, and handheld DVD players w/ headsets and interesting videos
•  At our coffee bar, enjoy a variety of coffee & teas, including Vermont Green Mountain blend, bottled water and tea beverages along with healthy snacks. 
•  Please bring a light lunch in case you stay with us.  We do have cold storage available.
•  Plan on 7-10 days of restricted activity

After Surgery

Keep in mind there will be restrictions on activities for 7-14 days.  Once your surgery is completed, we will review the care required for your surgery site and you will be given a set of written instructions on wound care from Dr. Callahan.  As a convenience to our patients, we have specially prepared SkinSmart wound care kits available for purchase.  You can expect to return to the office within 7-14 days for a suture removal or a wound check.  This appointment will be scheduled before you leave our office.