Mohs Micrographic Surgery: Smaller Scars, High Cure Rate
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- čas přidán 2. 07. 2013
- Mohs Micrographic surgery is a highly specialized procedure used to remove skin cancers from the face, head, neck, and shins and for removing larger tumors on the abdomen, legs or arms.
Mohs surgery is offered at three Dartmouth-Hitchcock Clinics locations: at the Heater Road facility in Lebanon, New Hampshire, and in the Manchester and Keene New Hampshire clinics.
Dartmouth Health, New Hampshire's only academic health system and the state's largest private employer, serves patients across northern New England. Dartmouth Health provides access to more than 2,000 providers in almost every area of medicine, delivering care at its flagship hospital, Dartmouth Hitchcock Medical Center (DHMC) in Lebanon, NH, as well as across its wide network of hospitals, clinics and care facilities. DHMC is consistently named the #1 hospital in New Hampshire by U.S. News & World Report, and recognized for high performance in numerous clinical specialties and procedures. Dartmouth Health includes its Dartmouth Cancer Center, one of only 51 National Cancer Institute-designated Comprehensive Cancer Centers in the nation, and the only such center in northern New England; Dartmouth Health Children’s, including the Children’s Hospital at Dartmouth Hitchcock Medical Center, the state’s only children’s hospital and clinic locations around the region; member hospitals in Lebanon, Keene and New London, NH, and Windsor, VT, and Visiting Nurse and Hospice for Vermont and New Hampshire; and more than 24 clinics that provide ambulatory services across New Hampshire and Vermont. Through its historical partnership with Dartmouth and the Geisel School of Medicine, Dartmouth Health trains nearly 400 medical residents and fellows annually, and performs cutting-edge research and clinical trials recognized across the globe with Geisel and the White River Junction VA Medical Center in White River Junction, VT. Dartmouth Health and its more than 13,000 employees are deeply committed to serving the healthcare needs of everyone in our communities, and to providing each of our patients with exceptional, personal care.
Learn more at www.dartmouth-health.org/
![Squamous Cell Cancer [Dermatology]](http://i.ytimg.com/vi/DYHImpEuAVM/mqdefault.jpg)
Thanks God after my Mohs operation in UWMC , madison, wisconsin last yr., i am now free of cancer. I got very, very good surgeons. Thanks God..❤❤❤❤
God bless the Mohs surgeons! I've had three of these procedures and each went well! Very, very little pain, and I didn't need Tylenol. There are no scars. My dermatologist was an artist! Never wait to see a doctor and opt for this Mohs procedure if you can. Wear sunscreen.
I recently underwent a Mohs procedure for a squamous cell carcinoma. My husband just this week had his fourth Mohs - separate sites, 3 for melanoma. Our outcomes have been excellent with very little evidence of surgery. We are fortunate to have a Skin Surgery Institute locally. It is a blessing - and always busy.
This should be shown in schools and to teenagers 🙏🏻💛
in Europe and the Middle east it is, which is why they produce so many doctors, emphasize math and science
This should be mandatory viewing for anyone wishing to use a tanning bed....exxcellent video!
I have had many Mohs surgeries and they have always been great.
This is an excellent video. I'm having Mohs on my face in a few weeks. I wish I could have it done at this facility.
I'm facing this surgery and it was a big help, thanks
Nicely explained. I understood lot more from this video, than from my text book.
Thank you so much for this excellent video. You have provided a great public service. I may have to undergo MOHS and you have put my mind at ease. Thanks very much once again.
Thank you for this video Although very scared for the surgery, I am more informed thanks to this video.
I have had this surgery twice. The first time on the top edge of my ear, and this required a graft on the back side of the ear. Understandably, this resulted in a little rippling on the very edge of the ear that really isn't very noticeable. It took seven times to the lab and a full day to complete the procedure as the cancer had really spread over the back of the ear. The next time was on the nose. I was shocked to see the photo if the wound before closure. That was scary. As it turned out the scar is a literally just a hairline. I highly recommend this method if needed. Every effort was made to reduce scarring and the process was pain free.
Very helpful, thanks!
Very informative. Thank you.
Excellent Video & Doctors😇
Curaderm does it 100%, required a bit more time and patience, but it is not so invasive and works in-depth of cancer tissues.
Getting ready to go in for my Mohs procedure tomorrow (not with this clinic). My basal cell is between my nose and cheek, just under my eye. It hurt bad enough when they injected the lidocaine prior to the biopsy, due to the sensitive area. Now that I have an open wound, I don't even want to imagine the pain of injecting lidocaine near the open wound area. I wish they would have just done the Mohs surgery the first time and got it all over with at once rather than doing a biopsy first, and coming back later. But I suppose since Mohs surgery is so time consuming, they might have wanted to be certain it was necessary. Can't believe I am in my thirties, and already have skin cancer. I'm terrified, but the way this video explained the procedure, I feel somewhat better. If anybody is reading this who uses tanning beds and never uses sunscreen, STOP. Trust me, even if basal cell generally is not aggressive and doesn't spread, this entire process is very terrifying, and who wants to have their face cut open??? Take care of your skin, and don't be an idiot like me. A tan is only pretty for a few years. When you get to be my age, and have skin cancer, it isn't pretty anymore.
Happy Hour I hope it went well. I’m 37 and might have a bcc on my face. Anyway I hope you’re on the road to recovery
@@christopherbuilder5354 Thank you so much! Everything went great. I had my stitches removed last week. The doctor created a skin flap from my cheek to minimize the scarring, as he did have to remove a rather large piece of tissue. It was no where near as bad as I thought it would be. The lidocaine injections were the worst part. Once it kicks in, everything else is a breeze. If it turns out you also need the procedure, there is nothing to fear. No lifting, bending over, or working out for about a week afterwards, and a little wound care for about a week, but other than that, there wasn't nothing much to it. Best of luck to you :)
HH. I just had the same procedure you did and in the same place this morning. I have a cool black eye right now. The doctor told me this would happen. They did it all in one shot. Got six stitches inside and out. Will go in next week to have them removed. This is my third Mohs procedure. So far no definitive scarring on the first two.
I'm having this procedure.i never used tanning beds or anything similar..I wear sunscreen....I'm a black woman..
@@corneliuscoble6297 Wow that's extremely rare. It's definitely a lot more common in those with lighter skin and more sun/UV ray exposure. That sucks that you still managed to get it :/
Thank you for answering my questions with the video.
I will be having this surgery this month on my lip this gives myself some hope for the to e being great video
Pamela Sylvester It’ll be Great to have it behind you!!! May God Richly Bless You with Peace of Mindfulness & Strength❣️ 🙏. 💪🏼
I want to be a Mohs surgeon but it is so insanely competitive to match fellowship
Thanks.
Just had this procedure. I look like Mike Tyson punched me in the eye without boxing gloves. Lol
I kinda
😂 You made me laugh and informed me at the same time. I’ll be having surgery in a couple weeks and I’m not sure what to expect but now at least I know there could be major bruising involved. Thank you!
Great insights, thanks!
Are the labs typically at the same location as the surgery,and checked the same day, or does it have to been sent out to another location?
The samples are analyzed on site, which allows tge surgeon to know if he needs to remove more tissue, or whether his job is complete.
I have had 7 moh's surgeries. 2 this year. 1 below eye in July and 1 last week on nose. I wont have any skin left in a few years. I am debating on curaderm next time.
What's the reason that you've had so many skin cancers? If you don't mind me asking, is it due to a genetic disorder?
@@monkiram i was a lifeguard thru high school and collage, no sunscreen, jetskied, never wore a shirt, i am Irish with blue eyes. Tanning beds in winter. So I have sun damaged skin.
@@tomcat6933 Oh wow, that sucks :( I hope you're doing better now!
@@monkiram it's been a year since my last surgery. Still healing. I have learned a lot about sun protection but too late.
Is there a Mohs specialty service hospital in Massachusetts
Having this Monday..7/12…on my arm. Now am paranoid that the other arm will pop out one of these nasty things.
My cancer is SCC and will be removed next week. Each is about 3/4 inch in diameter and both spots are on my right thumb. I don't see stitched happening but I could be wrong.
I was diagnosed 2 weeks ago, on the top of my left hand. They removed the nickle size elevated bump. It grew fast within 4 weeks, and became painful. Path Report was squamous cell carcinoma. I'm scheduled for Mohs surgery in 2 weeks. I have fair skin and burn easily. Good luck with your surgery.
does this work for stage 1a melanoma?
Do surgeons or dermatologists do this procedure ? I had multiple skin cancer removals and believed surgeons for most part and dermatologist wants to do Mohs on leg in two days - she did squamous removal on ankle and high infection - should I get another opinion
Surgeons do this, and only surgeons who have had the specialized training for this procedure. I've had it down twice and I was fortunate that there was a Moh's surgeon in my area.
I have to do this in 2 weeks on my chin. I fear this because I had a total knee replacement in Nov and the surgeon was great the first one is perfect however the 2nd one the PT tech removed the stitches too soon and I have a 3 inch place on the top that looks like a knife was dropped. The doc would be upset but sadly he took his life 10 days after my surgery. I'm strong but I'm really afraid what I will end up with. After 40 yrs of marriage 2 yrs ago my husband died and I was just thinking about getting out and meeting ppl and now seeing this I'm worried,
What if the d I ctor finds it in your lung but doesn't look to where it is in the lung ?
I'm having mohs surgery on the 29th. Im terrified. Mine has taken over my left nostril eaten almost all the way thru. It's the size of a dime and looks hideous . Due to the covid 19, my surgery kept being put off. Mainly because I had 2 immediate family members , my brother this last December and my mom in April of this year. Right at 4 months apart I lost half my family. My cancer didn't look horrible until my mom who was suffering written early stages of Dementia and punched me in the nose really hard. It caused what looked like a small pea sizes area to burst open and there was what looked like a wart, turned inside out. It's not pretty and it's like the tip of an iceberg, the worst is underneath. The first option is a cheek flap, because I have a short forehead from the hairline down to keep hair from growing out of the top of the left nostril. If I had my identical twin sisters forehead. It would end up liking like a face lift. At 56, I sure need one. I lost almost 100lbs and my skin is very saggy. That could take 20 to 25 years off of my face. Lol darn it, I only get half a face lift. I'm willing to let them do the right side as well, to have a complete face-lift. Lol I have to laugh, if not, I'm going to lose my mind before I make it to surgery 9 days from now.
How did everything go? I hope well.
Always have a plastic surgeon do this type of surgery.
Just had this done on forehead. The numbing medicine was torture!
Anyone else have that issue?
Gina, in the future, ask them for something to relax you and ask for a topical anesthetic similar to what your dentist gives you before the anesthetic injection.
Gina, I just had the lesion on my nose biopsied. The needle itself didn't hurt (maybe because my nose is big and fatty - LOL!), but, boy, did that medicine burn like heck. After that, the procedure didn't hurt at all. Think it's not the same numbing medicine the dentist uses, as the dermatologist went right to work after the injections. She told me the face is very sensitive. In 2 weeks I go to a dermatological surgeon that is also a professor. Have many more lesions, so I can expect a biopsy every 6 months, followed by a surgery. Will say I didn't take so much as an aspirin after the procedure, because the anesthetic was long-lasting. The upshot of all this? The sun can be a killer. Don't ignore "pimples" that don't heal, lesions that bleed at the slightest touch (washing my face with my bare hands) and moles, even after being there for years, start changing. Throwing away my ball caps, using SPF 50+ cream and wearing sun resistant hats with wide brims.
yes it hurt there but the nose was torture for me. By the way, I just had it done on my forehead and now my eyebrow is higher than the other one. I am really worried They said it will calm down but I'm worried it's permanent. Did you experience anything like that?
@@mimi7914 no. They tried to close mine from between eyes to hairline... an had to stop for some reason... Ended up closing from side to side.
How did they close yours?
@@ginaprice2370 I think just in the middle. I hope it gets better on its own. So sick of surgery!
Can you go to work the next day? I have a desk job, no physical activity required. Will I even want to or should i definitely take a day of rest?
I would rest ... best of luck ❣️
@@sarahbrennan1342 - I put in a time off request anyway, I have the time so why not. Thank you for responding and your well wishes.
NJA 3 I had it done .. a few years back... our health system is not great here so I was messed around a good bit.... I had to go online to find the best procedure and surgeon..lol and then I had pay to get it done... I had a skin graft and was left with nerve damage.. all because other doctors didn’t give me the right treatment or take me seriously But once it was done it was pure relief ....America seems way ahead with this ... take care ... let me know how you get on 🙏🏻🌺🙏🏻
@@sarahbrennan1342 Thank you, I will let u know how it went. It’s right on the side of my nose.
@@sarahbrennan1342 Well, I had the procedure yesterday. It took them 3 attempts until there were no more cancer cells left. A plastic surgeon closed me up. I was there from 8:30 until 4pm. A whole lot of waiting. The closure looks nasty, it runs from the top of my nose to the nostril. It was a little painful last night, but bearable. I thought it was going to be worse today, but I have to say, I felt pretty darn good considering. The bandage comes off tomorrow, and right now is my only complaint so I guess I am doing ok. I heard a few people talk about nerve damage, but it’s supposed to come back in time. I really appreciate you taking the time to respond and for your well wishes, thank you so much and the best of everything to you.
What is the situation when the tumor is as big as a football, say in the groin or thigh?
This surgery sounds perfect for small cancers on face and extremities.
Sally, large tumors are operated on in the hospital under general anesthetic.
@@monicaperez2843 yes. That’s what they did for me.
Hello everyone, do you have an idea of how much this surgery cost?
I paid $800 out of pocket, way back in 2008, plus having insurance.
I looked on the internet and saw $2400.00. But I am sure it varies depending on the extent of the surgery and the time involved.
@@teresaharris-travelbybooks5564
Mohs surgery on lower leg
Just to let you know, I discovered a mole on my scalp that I am certain was melanoma, I got rid of it by mixing epsom salt and water and bringing it to a boil to form a paste and then applied that on it while still hot and covered it with a band aid twice a day and it was gone within 9 weeks! (you can just set a portion aside after it hardens and use it again day after day by just warming it up on the stove and adding a bit of water to it), it was a darkish glowing black color with a lump underneath about half the size of a dime, it had been there for about two years but I didn't notice it as it was behind my ear. I also eliminated all sugar and meats except for fish and replaced my morning breakfast with hummus on toast but these days I would look into couscous instead, very nutritious and no sugar!.. Also drink lots of water and get your vitamin c from fruits, and drink carrot and celery juice every day! In re. to couscous, it is excellent in the morning with a mix of chopped fried red peppers, garlic, onions, carrots and green peas adding curry powder and a bit of red chili powder! Very filling and tasty with a glass of orange juice! I am not a doctor but I can tell you that switching your diet to salads for breakfast, lunch and dinner instead of cooked foods will also greatly improve your chances of recovery! Its what I ate through out the time I had it, it was a very black glowing looking mole and its still gone today two years later.. Just so you know, cooking tends to kill nutrients.. Also stay away from electromagnetic frequencies and stress that weaken your immune system, get out and walk one hour or two hours each day! oxygen is very good for the body and mind as well as eating dried seaweed every day, look for Japanese brands!. Also so there is a tablet called tagrisso for those with lung cancer but it could be helpful as well for other types, if anyone here has breast cancer, look up drday dot com, for breast cancer.. And Dr Tullion Simoncini also has great treatments that apparently work! All the best!
really can dermatologists perform such operations of plastic surgery? Is this legit?!
Exactly, Dermatologists as a general rule are specialists in the diagnosis of skin disease. However Mohs surgery( dermatologists not surgeons) involves both plastic surgical skills and pathology. Dermatologists (not really surgeons at all) are not trained to anywhere near the level of surgery as plastic surgeons are, and they are also not trained to anywhere near the standard of pathology as pathologists are. Having referred patients to a few Mohs surgeons recently I can honestly say that of about 4 cases, I would classify 3 as poor results. Two patients had extremely poor cosmetic results, whilst the third patient clearly had a substantial focus of BCC which was not initially excised ( 1 month after surgery a 0.5cm nodule was present immediately at the edge of the excision site)
I must stress I am NOT talking about this particular group of doctors in this particulate video. I am talking about Mohs surgeons ( dermatologists) in general.
I would suggest to get the best results, have a good dermatologist ( who has a particular interest in skin cancer rather than one with an interest in cosmetic procedures) perform the diagnosis. Then ask to be referred to a plastic surgeon with an interest in skin cancer excision.
I repeat Dermatologist are excellent at skin diagnosis, this is what their area of specialty involves. Plastic surgeons are experts in removal of skin cancers and repair of the defect. Each of these specialists will believe in themselves so much that they feel they can actually do the job of the other specialist, however they cannot, and evidence based medicine will clearly show this to be true. Ask a plastic surgeon about what type of skin cancer a particular lesion is, many have absolutely no idea. Some plastic surgeons regularly remove benign lesions ( including seb Ks) with large flap repairs. Many dermatologists have very little idea of how to repair a wound. I have patients that have come back from dermatologists with very poor scars.
Basically most doctors are quiet good in their OWN FIELD of medicine. But many are very poor or have no idea when they begin to step outside their field of expertise.
Surgery: The branch of medicine that employs operations in the treatment of disease or injury. Surgery can involve cutting, abrading, suturing, or otherwise physically changing body tissues and organs.Now that the definition of surgery had been clarified, let's take a look at the surgical training of a dermatology resident. Surgical procedures of the skin include biopsy (incisional, tangential, punch, and other varieties), soft tissue tumor removal (lipomas), excision of skin cancers. In addition, routine training includes cosmetic procedure such as neurotoxins (Botox, etc), soft tissue fillers (lip, face, hands), lasers (different varieties). Mohs surgery, where the same physician serves as both the surgeon and pathologist, is also part of residency curriculum.All fellowship trained Mohs surgeon have at least one year of targeted training, specializing in Mohs surgery and reconstruction. More rigorous programs have fellows observe over 2000 cases and participate as primary surgeon in over 1000. Dermatologic surgeons have contributed to reconstructive surgery in many ways. One example is Zitelli modification to bilobed flap, which became a modern day classic. Another flap received a "face lift" was a nasolabial flap. In addition, dermatologists perfected interpolated flaps under local anesthesia.To conclude, dermatologic surgeons excel at what they were trained to do: diagnose and treat skin disease, in the operating room and elsewhere.
@@bpw8139 I have multiple basal cell carcinoma. My Dr sent me to a general surgeon. Should I ask for a plastic surgeon with cancer experience instead? The big one is on back of my neck I have 2 more on my shoulders. 2 more on chest and at least 2 on my arms.... Kinda worried. You know the big c word cancer scares me and several kinds run in my family.
BCCs are considered very low risk skin cancers, which have almost no chance of spreading to the rest of the body. In addition when they are not on the head or neck region they are considered even less worrying as there are few important structures for the BCCs to affect (on the head and neck area BCCs may affect nerves and blood vessels which control facial movements etc). If you have BCCs in the areas you have mentioned then they are low risk and I'm reasonably sure any general surgeon could excise these easily.
If you had a BCC in a difficult area such as on the nose or around the eyes then I would recommend a good plastic surgeon with an interest in skin cancer.
I must add one more thing to what I have said here and above. That is the there is a great deal of variability in the expertise of different doctors within the one field. Thus I have seen very good plastic surgeons and very poor plastic surgeons. In the same way, many dermatologists will be excellent in their field or expertise and others much poorer. The point I made above is very general, thus Plastic surgeons in general will be far superior in Surgery, as many have done 4-6 years of JUST surgical training. Dermatologist in general will be far far superior in diagnosis of skin cancer and other skin conditions as they too have done 4-5 years of just skin disease diagnosis.
@@bpw8139 thank you. Yeah the one on my neck is size of a quarter. Lots pain in area round it though. There was a growth on eyelid but m family clipped most of it to be tested. I'm in a wheelchair so I'm Wheeling in sun alot. Think that's why I got em. Th e chest n arm ones should be easier too they are smaller. Thank you for the info....
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