What is Mohs Micrographic Surgery?
According to the Centers for Medicaid & Medicare Services (CMS), “Mohs Micrographic Surgery (MMS) is a technique for the removal of complex or ill-defined skin cancer with histologic examination of 100% of the surgical margins. It is a combination of surgical excision and surgical pathology that requires a single physician to act in 2 integrated but separate and distinct capacities: surgeon and pathologist.”
MMS is a highly effective and extremely advanced technique used in the treatment of several types of dangerous skin cancers (listed below). The process involves removing skin cancers in a systematic and gradual manner, where skin is removed layer-by-layer, and the complete depth and circumference is examined one cell at a time under a microscope until only cancer-free tissue remains. This ensures maximum effectiveness of cancer eradication with minimal damage to the healthy surrounding tissue.
Fellowship-trained Mohs surgeons, such as Dr. Hazany, have spent an additional 1-2 years perfecting their craft under the supervision of a world renowned Mohs surgeon, where they learn the most current and specialized techniques. The advanced techniques Dr. Hazany learned in his fellowship are particularly effective for areas that require precise reconstruction such as the face and those that require delicate precision such as the hands.
THE STEPS TO A MOHS SURGERY:
Mohs Steps Infographic
All three steps should ideally be performed by the same highly skilled surgeon that is familiar with the case from the start to the end of the reconstruction. In the first step, the part of the tumor that is visible to the naked eye is marked and removed. At this point the surgeon removes a thin layer of the remaining skin and prepares a sample for the microscope. The sample is then examined to search for any indication of remaining cancer cells. In the case that signs of high risk cells exist in the sample, the surgeon proceeds to remove another layer of remaining skin for examination until the sample is devoid signs of potential danger.
When the circumference and depth of the final layer reveal completely healthy skin cells, cancer free margins have been achieved and reconstructive planning begins. It is important to note that all three steps of Mohs surgery are performed while the patient is comfortable and awake and completely anesthetized using local numbing medicines. If mild oral sedation is necessary, that can also easily be made available to the patient to help take the edge off during surgery.
The Mohs Surgeon in Beverly Hills, California
Skin Cancer develops on the human body when the skin’s normal control mechanisms stop working properly. When normal skin cells die, they are replaced with new healthy cells. Cancer cells do not die; instead, they continue to develop as uncontrolled growths and become abnormal cells in the skin. Mohs Surgery created a solution for these abnormal growths of cells in the 1960s. The Fellowship Trained Dr. Salar Hazany, is revered for his meticulous removal of skin cancer cells. Patients of Dr. Hazany are amazed at the minimal scaring that is left behind. Located on Rodeo Drive in Beverly Hills, Salar Hazany MD provides world-class Mohs surgery right here in Los Angeles. Contact us today for your consultation.
BEFORE & AFTERS of MOHS SURGERY
WARNING: PHOTOS AND VIDEOS OF MOHS MICROSURGERY TEND TO BE GRAPHIC. PLEASE PROCEED WITH CAUTION.
MOHS BEFORE & AFTERS
WHY IS IT IMPORTANT THAT MY MOHS SURGEON BE FELLOWSHIP TRAINED?
In addition to a three year dermatology residency, fellowship trained Mohs surgeons undergo a rigorous two year training and specialization. This allowed for Dr. Salar Hazany to sharpen his surgical skills and perfect cutting-edge techniques under the supervision of an accredited group of physicians. During his fellowship, Dr. Hazany completed over 3000 supervised and solo complex reconstructions of the nose, eyelids, ears, lips, face, fingers, hands, feet, other extremities and genitals. Dr. Hazany is a member of the America College of Mohs Surgeons (ACMS), a prestigious organization for the top fellowship trained surgeons that requires continued education and community involvement. Many dermatologists perform Mohs Surgery without completing a fellowship or do so with inadequate training and minimal experience. Many of these surgeons are members of the American Society of Mohs Surgery (ASMS), an organization which has comparatively minimal criteria for membership. The differences in the surgeon’s training, technique, and experience are very apparent in the final product in side-by-side comparisons.
Read About Fellowship Training
Sports Mohs Micrographic Surgery for Athletes
Doing surgery on athletes and the physically active is an art and science. It is essential to understand the kinetics of movement and the underlying orthopedic anatomical structures in order to be surgically successful. The most common demand my patients present me with is the need to return to training within days of surgery. In this video we see a zumba instructor and owner of a family “farm to table” grocery store undergoing a large Mohs surgery procedure with reconstruction.
Mohs Success Rate and History:
The cure rate with Mohs surgery cited by most studies is between 97% and 99.8% for primary basal-cell carcinoma, the most common type of skin cancer. Mohs procedures are also used for squamous cell carcinoma, but with a lower cure rate. Recurrent basal-cell cancer has a lower cure rate with Mohs surgery, more in the range of 94%. (Source)
The Skill of your surgeon is very important in having a successful Mohs operation.
Post-Surgical Management and Wound Reconstruction
After an abnormality is removed, Dr. Salar Hazany’s reconstruction of the post-surgical wound leaves little to no trace of a scar. This is only possible due to his vast experience performing Mohs surgeries. Dr. Salar Hazany is fellowship-trained and has been apart of over 3000 Mohs surgeries.
Managing your wound post-surgery is an important part of the process. Dr. Salar Hazany always gives his patients detailed instructions for post-surgical management and follows up with in-office visits.
BEFORE & AFTERS MOHS SURGERY
WARNING: PHOTOS OF MOHS MICROSURGERY TEND TO BE GRAPHIC. PLEASE PROCEED WITH CAUTION.
MOHS BEFORE & AFTERS
When is Mohs Appropriate?
The following pathologic tumor subtypes can be treated with Mohs surgery (patient health status, size and location also play a role in appropriate treatment planning).
- Basal Cell Carcinoma
- Squamous Cell Carcinoma, Keratoacanthoma
- Bowen disease
- Lentigo Maligna and melanoma in situ
- Primary lentigo maligna
- Adenocystic carcinoma
- Adnexal carcinoma
- Apocrine/eccrine carcinoma
- Atypical fibroxanthoma
- Bowenoid papulosis
- Dermatofibrosarcoma protuberans
- Desmoplastic trichoepithelioma
- Extramammary Paget Disease
- Malignant fibrous histiocytoma
- Merkel Cell Carcinoma
- Microcystic Adnexal Carcinoma
- Mucinous Carcinoma
- Sebaceous Carcinoma
- Rare Biopsy proven malignancies not otherwise specified
SKIN CANCER TREATMENT IN LOS ANGELES | SALAR HAZANY MD
Skin cancer can be extremely dangerous. None are as skilled as Dr. Salar Hazany when it comes to performing Mohs micrographic surgery. Years of experience, treating this condition, and meticulous precision allows Dr. Salar Hazany to perform successful surgeries time and time again. His vast experience treating rare and “hard to reach” skin cancers gives our clinic the edge over other dermatologists who perform Mohs surgeries. Skin cancer can reveal itself in many ways and may afflict the face, scalp, neck, ears, and anywhere else where skin can be found. Dr. Hazany removes skin cancer in a permanent way. Do not hesitate to schedule your preliminary consultation today! As skin cancer is a time-sensitive issue, Dr. Salar gives his Mohs patients priority so that someone afflicted by this disease can be in surgery, as soon as possible.
Read more about Skin Cancer
Frequently Asked Questions Regarding Mohs
- What is Skin Cancer?
- Does Mohs Surgery Leave a Scar?
- Are Skin Cancers Life Threatening?
MOHS Surgery | What to Expect The Day of Surgery
Dr. Salar Hazany is a trained physician who spent years perfecting his skills as a micrographic surgeon. His fellowship training allows our patients to receive the absolute highest level of care possible.
You can expect on the day of your procedure to be full awake with the area being treated under local anesthesia. This allows for the appropriate incisions to made to remove your cancer. Mohs Surgery is known for its high success rates; by completely removing your skin cancer, the affected area can heal without any trace of cancer.
As you can see from Reviews on Yelp, Dr. Salar Hazany preforms Mohs treatments with little to no scar afterward.
Having the proper surgeon is the key to the success of a Mohs surgery. Studies have shown that a successful outcome occurs from more than 95% of cases.