Mohs surgery is a special technique used to remove skin cancers on certain parts of the body – without having to go to sleep. Using sensitive equipment, cancers are meticulously removed one layer at a time during Mohs surgery until all the skin margins are clear.
Mohs, named after Dr. Fred Mohs who pioneered the early technique in the 1970s, means smaller scars and lower recurrence rates for many skin cancers.
During Mohs, your treating doctor acts as both pathologist and surgeon, which means Mohs is the most comprehensive, safe, and accurate way to treat cancers in high-risk areas.
Mohs surgery has two main advantages:
Dr. Steven Eilers is the director of Mohs surgery at Knight Dermatology. Dr. Eilers is a fellowship-trained Mohs surgeon.
Dr. Eilers graduated magna cum laude from Northwestern University in Chicago and earned a full merit scholarship to the University of Chicago Medical School. He completed his dermatology residency at Rutgers University.
He finished his Mohs surgery and cutaneous oncology fellowship with a well-known practice in New York. Dr. Eilers practiced Mohs surgery in Texas before joining Knight Dermatology in 2020. While he is from Chicago, his family now calls Naples home.
Dr. Eilers personally performs all Mohs surgeries at Knight Dermatology, which includes elimination of your skin cancer and reconstruction of tissue after excision. He directs the Mohs operative team, who are committed to treating our patients with care and compassion.
During Mohs surgery, you remain awake and alert. This means Mohs can be safely performed in our offices without having to go to the hospital or an operating room.
On the day of your surgery, Dr. Eilers will first examine the area to be treated and talk with you about the plan for your care. Once all your questions are answered, the Mohs team will prep you for the first stage of Mohs: removal of your skin cancer. This includes giving you an injection of local anesthetic. After the 1st excision is performed (the 1st “layer” or “stage”) you’ll be bandaged so that you can wait comfortably. You’ll be free to wait in our Mohs waiting room, read, watch movies, check e-mail, or whatever you desire.
While you wait, the Mohs team will be preparing the excised tissue, placing it on glass slides, and delivering it to Dr. Eilers so he can look at your tissue under a very sensitive microscope.
If cancer cells are found, you’ll need another layer of skin removed. This process of removing a thin layer of skin and looking at it under a microscope continues until the surgeon no longer sees cancer cells.
Once cancer cells are no longer seen with the Mohs technique, Dr. Eilers will speak with you about how to repair your wound. Some wounds heal nicely without doing anything further. Most require stitches. Some wounds are larger, and require advanced repairs like skin flaps or grafts.
Rest assured that Dr. Eilers has extensive training in all types of wound repairs, and will work with you to achieve the best possible scar after your Mohs procedure.
Mohs is not required for all skin cancers. In fact, most insurances (including Medicare) will not pay for Mohs unless your cancer meets certain criteria.
Mohs is usually recommended when a skin cancer:
Melanoma, the most serious and life-threatening skin cancer, is treated differently than basal and squamous cell cancer. Mohs is occasionally recommended for certain early types of melanoma.
When treating melanoma, the we use a modified type of Mohs surgery called slow Mohs. It’s called slow because it’s not possible for the surgeon to look at the removed skin and know right away whether it contains cancer cells. More time is needed.
If you have slow Mohs, your surgeon will remove the visible skin cancer and a bit of normal-looking skin around it. You’ll then be bandaged and sent home.
Most patients return the next day. It’s then that the patient learns whether more skin must be removed or the wound can be closed. Again, some wounds are left to heal on their own.