Mohs Surgery

Mohs micrographic surgery is recommended when:

✔ Skin cancer is in cosmetically sensitive or functionally important areas (face, ears, hands)
✔ Skin cancer is aggressive or deep
✔ Cancer has recurred after previous treatment
✔ Tumors have poorly defined edges

Because of its precision, Mohs surgery delivers cure rates up to 99% for common skin cancers and is considered the most effective option available.

For every extraction of tissue, a specimen is processed. Our Mohs surgeons, Dr. Josh Hammel and Dr. Nedyalko Ivanov, examine the sliced tissue sections and determine whether the samples have cancerous cells. If cancer is found, the location is noted on a reference map (tissue drawing). The surgeon then takes out the specified cancerous tissue. This procedure is repeated until the cancer can no longer be found.

A basic procedure of the surgery is as follows:

• Surgical removal of tissue (surgical oncology)
• Mapping the pieces of tissue
• Freezing and cutting the tissue at 5 to 10 micrometers using a cryostat
• Staining the sample with hematoxylin and eosin (H&E) or other stains like Toluidine Blue
• Pathology: Interpretation of microscope samples on the slides
• Possible reconstruction of the surgical imperfection (reconstructive surgery)

Mohs surgery is most often used for basal cell carcinoma and squamous cell carcinoma. Certain high-risk melanomas may also be candidates for specialized surgical management.

A tiny scalpel is used to cut around the evident tumor. Also, a small surgical margin is utilized, typically with a 1 to 1.5 mm free margin (uninvolved skin). The standard cutting out of skin cancers requires 4 to 6 mm of free margin.

Mohs surgery is normally used to treat two of the most common forms of skin cancer, squamous cell carcinoma and basal cell carcinoma. The process is also used in other types of skin cancer, such as melanoma. The technique is commonly selected because its precision preserves more healthy skin, which is especially helpful for surgery on high-visibility areas, including the face and neck. The Mohs method is the best technique for cosmetically sensitive areas of the face like the lips, nose and ears or near the eyes.

In many cases, yes. Goodman Dermatology works with your insurance to verify coverage and guide billing.

All surgical procedures leave some degree of scarring, but Mohs is tissue-sparing and typically results in minimal scarring. Our team provides reconstruction options to optimize cosmetic results.

What is a Mohs surgeon?

An expert Mohs surgeon is highly specialized because becoming a Mohs surgeon requires extensive education and experience. A dermatologist first has to complete residency training before entering a Mohs surgery professional association, assuming certain eligibility requirements are met. Some of the most esteemed credentials are the American Society for Mohs Surgery (ASMS) and the American College of Mohs Surgery (ACMS). Dr. Hammel and Dr. Ivanov are fellowship-trained skin cancer and reconstructive surgeons associated with ACMS. They specialize in Mohs micrographic surgery and other dermatological surgical procedures and have performed thousands of procedures.

They stay current with the latest technological advances and are known for their outstanding bedside manner. Dr. Hammel and Dr. Ivanov are among the most sought-after surgeons in Georgia and beyond.

Mohs is performed in in Buford, Canton, Dawsonville, Roswell and Smyrna. Goodman Dermatology provides patients in the North Georgia and Atlanta Metro areas with a variety of beauty treatments and dermatological health services.

If you have concerns about any spots or growths on your face, Contact us at (770) 754-0787 today to schedule your appointment. Skin cancer is much easier and less invasive to treat when caught in its early stages.