Will the Surgery Leave a Scar?
Yes. Any form of surgical treatment will leave a scar. However, the Mohs technique tends to minimize this as much as possible.
Should Plastic Surgery Be Performed?
Selected surgical wounds created by Mohs surgery may be allowed to heal on their own. In some cases this will result in a cosmetic appearance equal or superior to that which could have been obtained by plastic surgery. The cosmetic appearance continues to improve for at least a year after surgery. At this point, plastic surgery may be considered if the result is unsatisfactory. In this way, unnecessary surgery can be avoided.
While Mohs surgery is a highly effective treatment for skin cancer, no method of treatment is successful in all patients. In those few patients who do have a recurrence, the tumor usually becomes apparent within 12 months following Mohs surgery. Immediate plastic surgical repair of the Mohs wound may distort and cover up tissue that still contains cancer cells. For this reason, we may recommend that your wound be allowed to heal on its own if we feel there is a significant risk of tumor recurrence.
In cases where spontaneous wound healing would produce an unsatisfactory result, and the risk of tumor recurrence is felt to be minimal, plastic surgical repair may be indicated. Although plastic surgery may reduce scarring and improve the cosmetic result, you will not look exactly as you did before surgery. In some patients, however, plastic reconstructive surgery may result in an appreciable difference. Dr. West has a great deal of experience in plastic surgical repair of Mohs surgery defects, and repairs the vast majority of them himself on the day of Mohs surgery. In unusual cases, a plastic surgeon may be consulted to handle the repair. Dr. West will be able to advise you about this after your skin cancer has been removed. If you prefer to see a plastic surgeon for management of the surgical wound, you are welcome to do so.
Will My Insurance Cover Mohs Surgery?
Many health insurance policies cover the entire cost of Mohs surgery; others provide at least partial coverage. Some insurance plans require that you obtain prior authorization for surgery or a referral from your primary care physician before coverage is granted. Please check with your insurance company for questions regarding cost and insurance coverage. Our office staff may also be of assistance.
Will I Ever Be Cured?
Many patients are referred to us for Mohs surgery because other forms of treatment have failed to cure their skin cancer. If this is your situation, it does not mean you are cancer-prone or have a hopeless case. It simply means that the methods used to treat you in the past were not effective enough to destroy or remove all of the skin cancer cells. Because of meticulous microscopic control, Mohs surgery cures almost all patients, even those in whom skin cancer has persisted after several previous treatments.