What is Mohs Surgery?
Snyder Dermatology, located in Austin and Round Rock, TX, offers Mohs Micrographic Surgery with our board-certified dermatologist and fellowship-trained Mohs surgeon, Dr. Nikki Dietert. This technique is used to treat basal cell and squamous cell cancers of the skin, as well as other less common types of skin cancer.
Mohs Micrographic Surgery is a technique developed by Dr. Frederic Mohs in the 1930s. This precise technique has a cure rate of up to 99 percent. The technique is unique in that the Mohs surgeon is also the pathologist, examining 100 percent of the tissue margins on the day of surgery. This ensures microscopic removal of the tumor and its roots with the highest precision. The skin cancer is removed, treated with a special dye, and processed by freezing and cutting to place the tissue on microscope slides. The surgeon then examines the microscope slides to determine if more tissue needs to be removed to clear the skin cancer. The process is repeated until the tumor is clear.
This specialized technique allows for removal of less heathy tissue, overall decreasing tissue margins
and sparing as much healthy skin as possible. This helps minimize scarring and is ideal for visible,
cosmetically-sensitive areas. By performing pathology on the same day, this also eliminates the wait
time of days for regular pathology results.
As this is an intricate and detailed surgery, it is imperative to be treated by an experienced board-certified dermatologist with specialized Mohs training. Dr. Dietert completed a Mohs surgery fellowship following her dermatology residency. During fellowship, Mohs surgeons are also trained in wound reconstruction techniques once the skin cancer has been removed. In addition, our practice includes an on-site plastic surgery center and plastic surgeon should consultation be needed.
FOR MORE INFORMATION ABOUT MOHS SURGERY, VISIT:
The day of surgery, the area will be numbed using a local anesthetic. The visible portion of skin cancer is then surgically removed with a small margin. This removal is done in a specific fashion to ensure the entire under-surface and skin edges will be examined microscopically. The tissue is then processed in the lab to prepare microscope slides. The surgeon then reviews the tissue under the microscope to identify if and where residual tumor remains. This is drawn onto a map that coordinates with tumor location on the patient. Subsequently, the process is repeated until there are no more cancer cells present.
Once the skin cancer is removed, repair options will then discussed to determine how to best manage your wound. Certain areas may be allowed to heal on their own. Smaller wounds can usually be closed side-to-side with sutures. Larger wounds may require a skin graft of flap. Under certain circumstances, a Plastic or Oculoplastic surgeon will help assist in closure. If required, this is usually planned for ahead of time to coordinate with the Plastic surgeon.
"As usual, Dr. Aranda goes above and beyond in providing a personable care that is difficult to find. She takes the time to discuss various treatment options, discusses the pros and cons of each and genuinely values your input to collectively determine the best outcome. I feel so strongly about Dr. Aranda, Dr. Snyder and their professional staff that I still went to them last year when they were out of network. Thank you Dr. Aranda, you're just great!"- B.J. / Google / Mar 25, 2017
"Dr. Cervantes is wonderful. She listens carefully and is always willing to answer any questions you may have."- Anonymous / Healthgrades / Feb 15, 2019
"I didnt know what to expect coming here because some of the reviews on here say the staff is so rude. But i had the most pleasant experience here. From the moment i opened the door, i felt welcomed. The doctor herself was such a delight. She talked to me in a manner that made me feel so comfortable. She diagnosed me with something i kind of thought i had already, so now to see what the treatment does. I will see her again in three months. So overall, im glad i chose this office for my dermatology needs."- E.G. / Google / Feb 14, 2019
"I would highly recommend Snyder Dermatology, Dr. Cervantes and her staff are amazing! From the moment you walk into the office until the moment you leave you are greeted and made to feel welcomed. I was able to schedule an appt fairly quickly and once there the waiting was not long. The staff was very friendly and helpful. I had a procedure done and was very anxious and nervous, Dr. Cervantes made me feel comfortable as she explained everything to me. My daughter was treated for acne as well and her experience here was wonderful. Dr. Cervantes made her feel special. Call....You won't be disappointed."- M.B. / Yelp / Feb 14, 2019
"Dr Cervantes is great!!!! She is very easy to talk with and I feel she did a thorough skin exam... I have had to do regular skin exams for about 10 years due to precancerous spots on my face and back. I started going to Snyder dermatology 2 years ago and feel Dr Cervantes is the Best I have seen!!"- J.H. / Yelp / Feb 13, 2019
What to Expect
Mohs surgery is performed on-site at our office in Round Rock, Texas. As the process is detailed, there is some waiting time on the day of surgery in between skin cancer removal while the tissue is processed for microscopic examination. The length of wait time depends on the number of layers required to completely remove the cancer. On average, one to three rounds of removal are typically required, with each round taking approximately one hour of wait time.
The wound will then be repaired with sutures or may be allowed to heal without sutures. If a Plastic surgeon is consulted, they will repair the wound after the Mohs process is complete.
Dr. Nikki Dietert will see you in consultation prior to scheduling surgery. It is essential to
bring a list of all medications that you are currently taking. In addition, the surgeon should be informed of
- Current use of any blood thinner/anticoagulant
- Prior history of heart disease or stroke
- If you have a pacemaker or implanted defibrillator
- History of joint replacement
- If you require antibiotics before a dental procedure
- Any allergies to medications or medical equipment such as latex
- Smoking status
- Previous Mohs surgeries and skin cancers
After Mohs surgery, we will provide detailed aftercare instructions and ways to manage discomfort. Activity limitations will be discussed with Dr. Dietert. While the majority of patients are able to return to normal activities by the next day, patients must refrain from taking part in strenuous exercise for 1 – 3 weeks. Wounds that required sutures will need a suture removal visit ranging from 6– 14 days following surgery. Additional follow-up may be required and will be scheduled as necessary.
Schedule Your Consult
For any skin cancer patient considering Mohs micrographic surgery as a treatment option, it is extremely important to find the right dermatologist and surgeon. The success rate of this skin cancer treatment is highly connected to the experience and care of the surgeon performing it. At Snyder Dermatology, our team of doctors work together to diagnose, treat, and manage skin cancer, and will work closely with the patient to map out the best course of treatment. Call our Round Rock, TX dermatology office today to schedule a consultation.