Mohs Micrographic Surgery
Mohs surgery is a highly specialized treatment for the removal of skin cancers. Mohs surgery is named in honor of Dr. Frederic Mohs, the physician who developed the technique. It is typically a one day, outpatient treatment which allows for selective removal of the cancer while preserving as much of the surrounding skin as possible. This method differs from other methods of treating skin cancer by the use of microscopic examination of all the tissue removed surgically as well as detailed mapping techniques to allow the surgeon to remove only areas involved with cancer to ensure complete removal.
What are the advantages of Mohs?
By using the detailed mapping techniques and complete microscopic evaluation, the Mohs surgeon can pinpoint areas involved with the cancer that are otherwise invisible to the naked eye. The benefits are:
- The highest cure rate, typically 99%
- Minimizes the amount of healthy, undiseased skin removed resulting in a smaller area/defect to be sutured/repaired
- Usually a one day outpatient surgery using local anesthesia
Dermatology Associates of Georgia is proud to offer our patients two board certified and Fellowship trained surgeons with expertise in performing the Mohs procedure.
Our fellowship trained Mohs surgeons, Carl V. Washington, MD, and Maren E. Cotes, MD, both perform the surgery covering all four office locations.
Carl V. Washington, M.D.
Decatur, Johns Creek, Monroe & Piedmont
Dr. Carl Washington joined Dermatology Associates of GA after spending 23 years on the faculty of Emory University School of Medicine Department of Dermatology, where he was involved in the training of 18 Fellows in Mohs Surgery, and hundreds of Dermatology Residents. He completed medical school at The University of Michigan, and a residency in Dermatology at Henry Ford Hospital. Following this, he completed a Fellowship in Mohs and Dermatology Surgery at Duke University School of Medicine. At Emory, and at Dermatology Associates of Georgia, Dr. Washington’s clinical expertise is in Mohs Surgery for the management of skin cancer, and the treatment of patients with melanoma and high risk pigmented lesions.
Maren E. Cotes, M.D.
Decatur, Johns Creek, and Monroe
Dr. Cotes was raised in New Hampshire and received her Bachelor of Arts at McGill University in Montreal, Quebec, before completing her medical training at Dartmouth Medical School. After receipt of her medical degree she completed an internship in General Surgery at Dartmouth-Hitchcock Medical Center before moving to Atlanta to pursue her Dermatology training at Emory University. Following her residency, Dr. Cotes continued her surgical training at Emory as a Fellow in Procedural Dermatology. She joined Dermatology Associates of Georgia in 2015. Her clinical interests include Mohs surgery and all aspects of cutaneous oncology.
What To Expect
Preparing for Surgery
- Avoid aspirin, over the counter pain medications (such as Ibuprofen, Aleve, Advil, etc), vitamin E, or herbal supplements for 7-10 days prior to the surgery.
- Tylenol (acetaminophen) is OK to take before the surgery.
- Continue all other prescribed medications, unless instructed otherwise.
- Avoid alcoholic beverages and smoking for 24 hours prior to surgery.
- Be well rested with a good night’s sleep. Eat a good breakfast/lunch on the day of the surgery, as you may be in the office for several hours.
- Please do not wear make-up, jewelry or nail polish.
- You usually can drive yourself home after the surgery, but sometimes a driver is needed if the surgery is around the eye.
- As your procedure may take several hours, please feel free to bring a book, magazine, or digital device to your appointment. You are also welcome to bring a beverage/snack if desired. You may feel more comfortable dressing in layers, as your procedure room may be chilly.
The Day of Surgery
When you arrive for surgery, you will check in and then be called back by the assistant. Your doctor will discuss the procedure and answer any questions. The area to be treated will be cleansed and anesthetized with local injection. The tissue will be removed, photos will be taken, and a bandage placed on the wound. You will wait while the tissue is prepared and examined in the lab while we see if there is additional tumor that must be removed. If so, the doctor will take another layer of tissue and check it again. This may happen for several layers.
After the cancer is completely removed, a decision will be made on the best reconstructive method for repairing the wound created by surgery. Once the reconstruction is completed, a pressure dressing is applied. Although the average length of time is approximately 3-4 hours, you should plan on being there most of the day.
After the Surgery
Detailed written instructions will be provided. You should plan on wearing a dressing over the surgery site and avoid strenuous activities for about 1 week. Most patients report minimal pain which usually responds to Tylenol. You may experience tightness and numbness across the area of surgery which may take months to return to normal. You may also experience itching after your wound is healed. Redness, swelling, and bruising are common occurrences after surgery. Usually a return visit in 1-2 weeks is necessary to examine the surgical site and to remove the stitches. During the first few months, the surgical site may feel “thick”, swollen, or lumpy, and there may be some redness. Gentle massage of the area starting about one month after surgery may speed the healing process.
Should you have any questions or concerns prior to or after surgery or after, please call the office. To learn more about Mohs Micrographic Surgery, visit www.SkinCancerMohsSurgery.org or view this informative video.
Visit DermGA Today!
The Dermatology Associates of Georgia staff is committed to providing our patients with the personalized attention they deserve. For your convenience, we have several locations throughout the Atlanta metropolitan area including: Decatur, Buckhead/Piedmont, John’s Creek, and Monroe.