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Man With Smooth Skin

Skin Cancer Surgery: How Do You Choose a Mohs Surgeon?

Our culture promotes tan skin as a sign of beauty and vitality. However, sun-lovers have an increased risk of developing skin cancer, which is currently the most frequently diagnosed cancer in the United States. While tanned skin might seem beautiful when you’re young, it causes premature aging and potential scarring if you have cancerous lesions removed later in life.

If you skipped the sunscreen for years and have a skin cancer diagnosis, Mohs surgery is a highly effective treatment option for melanoma, squamous cell carcinoma, and basal cell carcinoma.


What is Mohs Surgery for Skin Cancer?

Mohs surgery is a precise treatment that removes cancerous tissue in stages to minimize the amount of tissue removed. It is the most effective way to remove basal and squamous cancer, with cure rates approaching 100%. 

During the procedure, a Mohs surgeon will remove visibly cancerous tissue and then temporarily bandage your wound. The surgeon then sections, dyes, and maps the tissue for examination. In the lab, the surgeon will examine each section for cancerous cells and maps their location. Using the areas indicated on the map, the surgeon will remove additional tissue and repeat the testing process.

The surgeon does this process as many times as necessary to remove every cancerous cell. The surgery could take anywhere from two hours to an entire day, depending on the size and depth of the cancerous growth.

One of the primary benefits of Mohs surgery is that it leaves much more healthy tissue intact than other skin cancer treatments. The surgeon uses a detailed maps to target cancerous cells and leave behind as much healthy skin as possible. The result is complete cancer removal with minimized scarring.

Once the surgeon has removed all of the cancerous cells, he or she will stitch the wound or perform precise reconstruction, depending upon the size and location of the wound. 


How Do You Choose a Mohs Surgeon?

There are two main certifications for Mohs surgeons: fellowship training and society-based.

Fellowship-Trained Mohs Surgeons

The American College of Mohs Surgery was founded in 1967 by Dr. Frederick Mohs, the pioneer of the surgical technique, and offers fellowship training in Mohs surgery, cancer pathology, and reconstructive surgery.  

After their dermatology residency and a competitive admissions process, fellowship candidates undergo an additional one to two years of rigorous hands-on training under highly-qualified instructors, during which they:

  • Practice a minimum of 500 Mohs surgery cases under the supervision of a Mohs fellowship-trained instructor.
  • Have exposure to rare tumor pathology (which they must remove and accurately interpret on a slide).
  • Remove tumors from difficult locations.
  • Practice complex wound reconstruction. 


Society-Based Mohs Surgeons

The American Society for Mohs Surgery provides Mohs certification to candidates who:

  • Complete a residency in dermatology.
  • Practice 75 Mohs cases (up to 45 of those could have occurred during the doctor’s dermatology residency).
  • Provide two letters of reference from Board-certified dermatologists.
  • Submit two Mohs cases that they completed post-Residency (including slides, Mohs map, report, and photos).
  • Receive a passing grade of 70% or higher on an exam that includes written and practical portions.
  • Participate in the ASMS peer review program for four years. 


Your Skin Cancer Surgeon Matters

Society-based Mohs surgeons may send you to a separate plastic surgeon for post-operative reconstruction. However, fellowship-trained surgeons undergo a meticulous training and certification process so they can do skillful, precise reconstruction themselves. If you choose a fellowship-trained Mohs surgeon, he/she will take care of you from the beginning of your surgery to the end. 

We know that scarring is a major concern for many patients, especially when removing skin cancer from sensitive locations like your face and neck. Our resident Mohs expert, Dr. Stigall, has publications in several medical journals about advanced facial reconstruction and melanoma treatment. As a fellowship-trained surgeon and Board-certified dermatologist, Dr. Stigall has performed over 5,000 Mohs surgeries. He is also one of the few Mohs surgeons in the country that has the specialized training to perform Mohs surgery for melanoma.

Vast experience is essential for the best pathology outcomes with the most minimal scarring, and Dr. Stigall’s experience and expertise speak for themselves. When it comes to cancer treatment, nothing less than the best will do, so choose a fellowship-trained Mohs surgeon.


Contact the Dermatology and Skin Surgery Center of Wilmington for all of your Mohs surgery, cosmetic, and general dermatology needs. Since 2001, Skin Surgery Center’s fellowship-trained Mohs surgeons and board-certified dermatologists have provided patients with exceptional treatment outcomes. Our professional staff is ready to provide you with the thoughtful, competent care that you deserve in our state-of-the-art facilities. Book your appointment today.


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