Mohs Surgery is a microscopically guided procedure for skin cancer removal. It was developed more than 60 years ago by Frederick Mohs (pronounced “Moze”), a medical student at the University of Wisconsin. Since that time, the technique has been advanced and refined. Today, it is considered the most advanced gold standard method for treating skin cancer in cosmetically sensitive areas and for certain other hard to treat cancers.
Lenny Henderson, MD: Dr. Henderson grew up in Edmond, doing his undergraduate studies at Oklahoma Baptist University. After a few years as a Certified Financial Planner, Dr. Henderson returned to his original dream of becoming a physician.
Dr. Henderson went to the University of Oklahoma College of Medicine where he was accepted into the prestigious academic honor society Alpha Omega Alpha for maintaining a 4.0 GPA through the first three years of medical school. Dr. Henderson did his dermatology training at OU Dermatology. He was fortunate to receive extensive training in Mohs surgery and reconstruction during his residency. He also did further preceptorship training in surgery at Oregon Health Sciences Center in Portland under Dr. Neil Swanson. Dr. Henderson a Board Certified Dermatologist and is a Fellow Member of the American Society of Mohs Surgery.
Dr. Henderson’s passion is the prevention, early detection and treatment of skin cancer. He uses a multitude of treatment methods, including Mohs surgery when needed according to Appropriate Use Criteria.
Dr. Henderson also enjoys treating general dermatology conditions in adults and children.
Roy Rindler, MD: Dr. Rindler is a native of Oklahoma and received his medical degree from the University of Oklahoma. He completed his residency training at the University of Oklahoma Department of Dermatology. He is a Board Certified Dermatologist and performs Mohs Surgery for skin cancer. Dr. Rindler is a Fellow Member of the American Society for Mohs Surgery.
Though most of a skin cancer is usually visible to the naked eye, microscopic cancer cells extend outside of the central cancer. If these extensions are not removed, the skin cancer may reappear. To guarantee removal of these microscopic areas, most physicians must remove a wide area of normal skin around the visible skin cancer. However, even with this safety margin, skin cancers removed with traditional treatments can return or require additional surgical procedures.
In Mohs Surgery, the tumor removal process is tracked microscopically. We are therefore able to best ensure that the entire skin cancer is cured while, at the same time, removing as little normal and healthy skin as possible. This is particularly important in cosmetically-sensitive areas. Of course, any procedure will leave a scar, but by preserving the maximum amount of healthy skin our physicians strive to achieve the best possible cosmetic result. You may learn more about Mohs Surgery at mohssurgery.org.
The size and shape of the wound depends upon the extent of the skin cancer. Though this cannot be predicted before surgery, it is typically several millimeters wider than the visible skin cancer.
Mohs Surgery is performed in our office at the Saints Dermatology Center of Excellence on an outpatient basis in a specially-designed suite. First, local anesthesia is used to numb the tumor site. Then, a thin layer of skin is removed, processed in our office and examined under a microscope. If any cancer cells remain, their locations are carefully diagrammed on a map. Using this map as a guide, another thin layer of skin will then be removed. Depending on the branching pattern of the tumor, this process may be repeated several times.
In some areas of the face, small wounds may look best if allowed to heal on their own. Most defects, however, require at least a few small stitches. Larger wounds may need skin flaps or grafts. Both techniques involve moving healthy skin into the surgical wound. Unusually large or complicated tumors may, however, require consultation with another sub-specialist.
Unfortunately, the type of repair needed for your wound cannot be determined until the entire skin cancer is removed. Remember—the primary reason for Mohs Surgery is to cure the skin cancer. Once this is completed our physicians will help you to achieve the best cosmetic outcome possible.
Each stage of surgical sampling takes only about 15 to 20 minutes, though an additional hour is then needed for our team to process and evaluate your specimen. Depending on the extent of your skin cancer, this cycle may need to be repeated several times throughout the morning until your entire tumor is removed. In most cases, our physicians will repair your wound immediately following surgery, but we may need you to come back the next day. Depending on the complexity of this procedure, this step may take between 15 minutes and an hour. Because we cannot predict the size of your skin cancer before surgery, it is impossible for us to determine how long the process will take. Please plan to spend your entire day with us. Hopefully, we will have you home much sooner.
Usually only one or two return visits are needed to repair, remove stitches or examine the healing surgical site. Afterwards, it is essential that you return to your referring physician for routine skin examinations
Scarring: A scar will always occur from surgery. Mohs Surgery should, however, result in the smallest possible scar. In most cases, scars begin as pink and bumpy and then fade slowly. Occasionally, minor procedures are used to improve the scar.