Skin Cancer (MOHS) Surgery
Complete Mohs and reconstructive treatment
Mohs Micrographic Surgery, developed by Dr. Frederic E. Mohs, has the highest cure rates—98 percent or higher for Basal Cell Carcinoma and Squamous Cell Carcinoma (the two most common types of skin cancer)–compared to other methods. Mohs surgery eliminates skin cancer cells, while also sparing the greatest amount of healthy tissue.
After having successfully completed his Board certification in plastic surgery, Dr. Dawes received fellowship training in Mohs micrographic surgery through a fully-accredited American College of Mohs Surgery (ACMS) training program. In Canada, Dr. Dawes is the 17th Mohs surgeon, and one of only two plastic surgeons trained in Mohs. This field, along with post-cancer soft-tissue facial reconstruction, remains his primary academic interest. His unique combination of plastic and dermatologic training allows most patients to have their cancers removed and the defect reconstructed on the same day, within the same facility and by the same surgeon. For patients who are out of town, or who have limited time or mobility, this arrangement is especially helpful.
Mohs surgery can be used to treat a wide variety of skin cancers, and is particularly useful for skin cancers that:
- Have a high risk of recurrence
- Have borders that are difficult to define
- Are located in areas that require as much healthy-tissue preservation as possible
- Are large or aggressive in nature
For areas where cosmetic appearance and function are especially important, Mohs surgery allows for maximized aesthetic and functional outcome.
Learn more about Skin Cancer and Mohs Micrographic Surgery.
How Mohs skin cancer surgery is performed
Under local anesthesia, Dr. Dawes will remove progressive layers of skin that contain cancer and examine them under a microscope. This ‘cycle’ is repeated until healthy, cancer-free tissue around the tumour has been achieved. Once the surgical margins are free of cancer, the Mohs surgery is complete.
Unlike other techniques, the excised tissues are examined as part of the procedure, thereby eliminating guesswork and sparing as much healthy tissue as possible. With Mohs high success rate, most patients require only one procedure for a particular lesion.
If needed, reconstructive surgery can be performed directly following your skin cancer surgery.
How long will it take to have my procedure from the time of my referral?
Wait times vary—ranging from two weeks to three months, depending on a number of factors. Priority is given to patients whose tumours are considered ‘urgent’ over patients with lesions of a less urgent nature.
Are there any medications I will need to stop taking before my surgery?
Prior to surgery and after obtaining a medical history—patients will be contacted with instructions about which medications to stop before surgery, and when they should stop taking them. In some cases, patients are referred to an internal medicine specialist prior to booking their Mohs procedure.
Should I bring someone with me to my appointment?
Patients may bring one close friend or family member with them to their appointment. This person may accompany the patient in the waiting room prior to the Mohs procedure and in between Mohs ‘stages.’ Elderly patients or those with limited mobility are encouraged to have someone escort them to and from the surgical facility.
Can I go to sleep for the procedure?
All Mohs micrographic surgery is performed under local anesthesia.
Will the local anesthetic hurt?
“I don’t like needles” is a phrase often heard in the clinic. The pain associated with the administration of a local anesthetic is difficult to avoid completely despite flawless technique. Dr. Dawes has injected thousands of patients and helps to ensure that they experience the least amount of pain possible. Typically, Dr. Dawes will use a combination of fast-acting and long-lasting local anesthetics to minimize the need for repeat injections.
How long can I expect to be at the surgical facility?
Patients should plan to be at the surgical facility from 8:00 am until 2:00 pm, unless alternately scheduled. On occasion, patients may be required to stay later. Snacks will be provided, though patients may bring a light lunch, if desired. Please arrange to have someone drop you off and then pick you up from the Calgary Mohs Surgical Centre (CMSC) at 2:00 pm. If we finish earlier (or if you will need to stay longer), we will call your ride to inform them.
Will my reconstruction be on the same day and within the same surgical facility?
Usually, yes. Occasionally, Dr. Dawes may have to delay the repair, or perform it under a general anesthetic at the Foothills Medical Centre.
Can I drive myself home following the procedure?
Patients should not drive themselves. We advise all patients to ensure they have a ride home from the surgical facility.
What if I have questions or concerns after the procedure?
Upon completion of the procedure, patients are provided with written instructions for wound care, along with a phone number to call 24/7 with questions or concerns. Alternatively, patients may book an appointment to see Dr. Dawes on an urgent basis to have their questions answered.
Where will I go for follow-up?
Usually, patients will return to the Mohs surgical facility for their follow-up appointment.
How often will I have to return for follow-up?
Most patients are asked to return for follow-up at six weeks and again at three months following their Mohs procedure and reconstruction. Specific instructions are provided for patients following their procedure(s).