Mohs Surgery

Discover the Gold Standard in Surgical Excision of Skin Cancers with Mohs Micrographic Surgery

The primary goal of treatment for skin cancers is the complete removal of the tumor through surgical excision, performed by a medical professional. The gold standard surgical method worldwide for the most effective removal of skin cancer is a technique called Mohs Micrographic Surgery or Mohs.

The aim of Mohs Micrographic Surgery is to excise the tumor entirely, reducing the risk of recurrence, while preserving vital tissue. This meticulous procedure involves the gradual removal of thin layers of skin, ensuring that every trace of cancer is eradicated while preserving healthy tissue. This approach guarantees that the outcome is a flawless balance between eradicating cancer and conserving normal tissue.

It is a privilege to be part of a Mohs and Reconstructive Surgery team at Summerhill Surgical Centre, as only a few surgeons are trained in Mohs surgery in South Africa. Under the expert guidance of dermatologist, Dr Johann de Wet, we aim to provide advanced techniques and compassionate care to our patients.

Furthermore, facing skin cancer on the delicate features of the face requires a meticulous approach to reconstruction. Even small excisions can pose challenges due to their proximity to vital facial structures like the eyes, nose, lips and ears. Our team understands the importance of not only removing the cancerous tissue but also restoring the natural contours of the face. By skillfully rearranging surrounding tissue, we aim to conceal scars while reconstructing critical structures to minimize any potential disfigurement or functional deficits.

Reconstruction after cancer treatment can be a journey that varies in complexity, often requiring multiple surgeries to restore both form and function. The excision and/or soft tissue loss will only be as big as the cancer. Our dedicated team understands the unique challenges you may face, and we are committed to supporting you every step of the way to ensure the best possible outcome.

Mohs Surgery Procedure

Surgery may be performed under local anaesthesia, sedation or with general anaesthetic, depending on the size and location of the tissue deficit, as well as the condition and the age of the patient. This is usually a day case surgery, but in cases where more extensive reconstruction is required, patients may need to stay in hospital overnight.

As expected, there will be a reasonable amount of downtime. Bruising typically settles in 10 – 14 days, while swelling may take longer, finally subsiding after approximately three to four weeks. Most facial wounds heal within two to three weeks, but wounds on the body may take longer (typically three to four weeks). Skin grafts on the lower leg can be timelier, depending on the blood supply. Scars can sometimes present as red and raised while healing and mature fully after 9 – 12 months. Fortunately, scars in elderly patients usually heal very well and are hardly noticeable with time.

Skin cancer patients are at a higher risk of developing a second cancer after their first diagnosis. Studies have shown that there is a 30% risk of developing a second primary Squamous Cell Carcinoma within 5 years after therapy for the first malignancy (Cutaneous Squamous Cell Carcinoma. N Engl J Med. 344: 2001; 975 – 983), which means lifelong follow-ups and skin checks are essential.

We recognize the emotional and physical toll skin cancer can take, which is why our compassionate care extends beyond the procedure, supporting you through the entire process.

Trust our dedicated team to guide you through the intricate journey of post-excision reconstruction and embark on a path of healing that restores not just your skin, but your peace of mind.

Travel

Providing Specialised Care for Skin Cancer Patients

We understand the importance of offering a peaceful and supportive environment for patients traveling from out of town or country to receive specialised care for skin cancer. Our self-catering cottages at Stellendal House provide a tranquil retreat, complemented by convenient airport and hospital transfers.

In addition to comfortable accommodations, we offer onsite treatments and expert advice to ensure the best possible outcome for your scar. Book a personalised consultation with one of our skilled skin therapists and explore the different possibilities of skin treatments.

We offer a variety of skincare solutions that include PDT light therapy packages, chemical peels and microneedling, expert advice on scar management, and long-term skin care strategies tailored just for you.

If you or a loved one are seeking exceptional care and personalised support for skin cancer treatment, reach out to us today. Let us be your partner in your journey towards healing and well-being. Our dedicated team is here to support you every step of the way during your surgery and recovery process.

Prevention

As for prevention, it is proven that regular application of sunscreen with SPF15 or higher for the first 18 years of life could reduce the incidence of non-melanoma skin cancer by 78%. Therefore, it’s vital to always protect your children from the sun’s damaging ultraviolet rays. More than five sunburns double one’s risk of developing melanoma but using a sunscreen with a SPF15 or higher daily, can reduce that risk to about 50% (and approximately 40% if one has squamous cell carcinoma). Ultimately, there is no reason not to apply sunscreen every day – it could reduce the risk of both melanoma and non-melanoma cancers and may even save your life.

The Most Common Types Of Skin Cancer

The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma and – the most dangerous of the three – melanoma.

Melanoma is the most feared form of skin cancer, arising from pigmented cells called melanocytes. Melanoma can develop from an existing mole or appear as a new, unusual growth on the skin. They are often asymmetrical, have irregular borders and display a variety of colours.

Surgery remains the primary treatment for melanoma. Your doctor may advise that you undergo Sentinel Lymph Node Biopsy (SLNB), depending on how deep the melanoma is.

There are currently many exciting developments underway when it comes to drugs used to treat melanoma, including drugs that stimulate the body’s own defences to destroy cancer cells (called immunotherapy) and drugs that target specific pathways the cancer cell uses to grow and replicate (known as targeted therapy).

Other common types of skin cancer include basal cell carcinoma and squamous cell carcinoma.

Basal cell carcinomas typically appear as pearly, waxy bumps, while squamous cell carcinomas manifest as red, scaly patches or open sores. These types of skin cancer are less aggressive than melanoma but still require prompt medical attention as they are locally destructive and can result in disfigurement and damage to critical facial structures. Squamous cell carcinomas can spread to distant lymph nodes and can also be more challenging to remove, since they are often large and occur more frequently on the face than melanoma.

Recognizing suspicious moles or pigmented lesions is crucial for early diagnosis and treatment. Regular self-examinations and visits with a dermatologist can help ensure that any concerning skin changes are addressed in a timely manner.

We recognize the emotional and physical toll skin cancer can take, which is why our compassionate care extends beyond the procedure, supporting you through the entire process. Trust our dedicated team to guide you through the intricate journey of post-excision reconstruction and embark on a path of healing that restores not just your skin, but your peace of mind.