Mohs surgery, named for Fredrick Mohs, was first conceived sixty years ago using chemical fixatives to allow tissue from the skin to be cut and examined for malignancy, but has evolved rapidly in recent years due to the ability to freeze tissue to allow a much faster turnaround. This breakthrough is what allows tumors that have recurred, are located close to vital structures, or which exhibit particularly aggressive features under the microscope, to be removed with 99% accuracy, and the defect to be surgically repaired, all in the same office visit.
Utilizing Mohs surgical techniques, the surgeon performs precise excision of the skin cancer in stages, one tissue layer at a time. The tissue is then processed onto microscope slides by a Mohs histotechnician. These slides are carefully examined under the microscope by the Mohs surgeon so that any microscopic roots of the cancer can be precisely identified and mapped. Unlike conventional techniques which only sample a small portion of the edges, around 1%, Dr. Ewanowski examines 100% of the edge and bottom of the tissue. When cancer cells are seen, an additional tissue layer is removed only in areas where the cancer is still present, saving as much normal, healthy skin as possible.
This tissue sparing technique results in a smaller post-surgical defect, and once the cancer has been removed entirely, Dr. Ewanowski will explain options for repair of the wound. The chances of developing a recurrence of your cancer is extremely low, less than 1%, in the skilled hands of a fellowship trained Mohs surgeon, such as Dr. Ewanowski. Dr. Ewanowski has performed over 20,000 Mohs surgeries.