Mohs surgery

Mohs is the most common and advanced procedure to treat skin cancer, yielding success rates up to 99 percent. Learn more about Mohs surgery below.

What is Mohs surgery?

Mohs surgery is considered the most effective technique for treating many basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs), the two most common types of skin cancer. Sometimes called Mohs micrographic surgery, the procedure is done in stages, including lab work, while the patient waits. This allows the removal of all cancerous cells for the highest cure rate while sparing healthy tissue and leaving the smallest possible scar. Click the button below to learn what the American Academy of Dermatology says about Mohs surgery.

American Academy of Dermatology

How is Mohs surgery performed?

The procedure is done in stages, all in one visit, while the patient waits between each stage. After removing a layer of tissue, the surgeon examines it under a microscope in an on-site lab. If any cancer cells remain, the surgeon knows the exact area where they are and removes another layer of tissue from that precise location, while sparing as much healthy tissue as possible. The doctor repeats this process until no cancer cells remain.

Depending on the location of your skin cancer, you may be able to wear your street clothes, or you may need to put on a hospital gown. The Mohs surgeon examines the spot where you had your biopsy and may mark it with a pen for reference. The doctor positions you for best access, which may mean sitting up or lying down. A surgical drape is placed over the area. If your skin cancer is on your face, that may mean you can’t see what’s happening, but the doctor talks you through it. The surgeon then injects a local anesthesia, which numbs the area completely. You stay awake throughout the procedure. Our Mohs surgery team has the ability to perform the procedure right on our vehicle, meaning your procedure can be done at a location that is convenient for you.

What are the benefits of Mohs surgery?

Mohs surgery is widely considered the gold standard of skin cancer treatment which allows for surgeons to see where the cancer stops during the surgery. Success rates with Mohs surgery are high for newly diagnosed cancers with rates as high as 99% for basal cell carcinomas and 98% for squamous cell carcinomas. Mohs surgery can also be very highly effective when treating reoccurring skin cancers, even if previous treatments have been unsuccessful.

Due to the minimally invasive nature of Mohs, it is often the preferred treatment for areas such as the face, hands, feet and shins. OnSpot offers Mohs surgery right on our mobile medical vehicle and our experienced staff is capable of completing the entire process in the time it may take you to drive to another dermatology practice.

What to expect during mobile Mohs surgery

Patients should expect to be at their Mohs appointment a minimum of 3 - 4 hours (this is because we can not predict how many stages the surgery will involve, as each case is unique).

Taking the initial specimen takes about 10 minutes.
You will be asked to wait in our waiting area once the initial specimen has been taken while you wait for it to be processed.
Processing the specimen takes anywhere from 30 - 45 minutes, as slides need to be created by our histotechnician then read by our surgeon to ensure all the cancer has been removed.
If the specimen indicates that there is still more cancer to be removed from the site, you will be brought back in for another layer.
Each additional layer adds another 30 - 45 minutes.
Once the surgeon has confirmed that all cancer has been removed from the site, they will stitch the area back together, this typically takes 20 minutes.
Once the surgeon performs the closure you will be instructed on how to care for the site, and you are all set.

What to bring on the day of your Mohs

Something to keep you preoccupied while you wait for your specimen to be processed.

Book
Crossword Puzzle
Sudoku Puzzle

OnSpot will supply you with lunch, water, and juice.

Mohs surgery team

Learn more about the incredible people that make up our Mohs surgery team.

Allan C. Harrington, MD

Medical Director & Mohs Surgeon

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Allan C. Harrington, M.D. is a graduate of Harvard College and Dartmouth Medical School. Board-certified in dermatology, Dr. Harrington completed his residency at Fitzsimons Army Medical Center. In addition, he completed a two year Mohs Micrographic Surgery fellowship at Tufts Medical Center in Boston, Massachusetts. He is a member of the American Academy of Dermatology and the American College of Mohs Surgery. Dr. Harrington is the former director of Skin Cancer Surgery at Walter Reed Army Medical Center and Assistant Professor at Johns Hopkins Medical Center. He is the author of numerous articles and textbook chapters on skin cancer and reconstruction.

Alexander Herbst, MD

Chief Medical Officer & Mohs Surgeon

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A graduate of the Florida State University College of Medicine, Alexander T. Herbst, M.D., completed his residency in Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine where he additionally served as Chief Resident. Special awards and honors included Intern of the Year, the Irving and Eva Mills Dermatological Surgery Certificate, and the George Ioannides Teaching Award. Dr. Alexander continues his work with the University of Miami where he enjoys participating in the education and training of medical students and resident Dermatologists. His work to advance medical and surgical dermatology has been included in textbooks and published in multiple academic journals. He holds board certification in Dermatology as well as Micrographic Dermatologic Surgery (MDS), commonly referred to as Mohs surgery. Dr. Alexander is a native of South Florida and he is excited to bring his passion for thorough, personalized medicine directly to his community through his work with OnSpot Dermatology.

Jay Herbst, MD FAAD

Mohs Surgeon

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Dr. Herbst attended medical school at the University of Miami, and then completed two full residency training programs. He completed both Internal Medicine and Dermatology residencies at the University of Miami-affiliated hospitals and Mount Sinai Medical Center, and is Board-Certified in both specialties. He is recognized throughout the country as an outstanding academician, researcher, teacher, and practitioner. He has published over 40 medical journal articles and textbook chapters, and has lectured extensively at medical conferences. Dr. Herbst is a Fellow of the American Academy of Dermatology, and is a member of the American Society for Mohs Surgery, Florida Society of Dermatology and Dermatologic Surgery, American Medical Association, and the Florida Medical Association.

Sergey Arutyunyan DO, MS

Mohs Surgeon

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Dr. Sergey Arutyunyan is a Dermatologist and Mohs Surgeon. He earned his medical degree from Nova Southeastern University College of Osteopathic Medicine in Fort Lauderdale, Florida. While in medical school, Dr. Arutyunyan was named 2015-2016 East Florida Physicians Alliance Scholar for his outstanding academic and research achievements. He was also inducted into Sigma Sigma Phi National Osteopathic Medicine Honors Fraternity. Furthermore, while at NSU, Dr. Arutyunyan was selected to serve as NSU COM research fellow, a prestigious opportunity allowing him to serve as Principal and Co-Principal Investigator for several research studies. As a medical student, he also received NSU Health Professions Division Research Grant, an accolade usually reserved for faculty led research.

After medical school, Dr. Arutyunyan completed his Internship at Larkin Community Hospital in Miami, FL where he received “Intern of the Year” award. He then went to complete Dermatology and Cutaneous Surgery Residency at Larkin Community Hospital where he served as a Chief Resident. He then pursued a fellowship in Mohs Surgery at the Skin Institute of South Florida under the mentorship of Dr. Eli Saleeby and a fellowship in Cosmetic Dermatologic Surgery at Hollywood Dermatology and Cosmetic Surgery Specialists under the mentorship of Dr. Eduardo Weiss. During the fellowships, Dr. Arutyunyan performed over a thousand cases of Mohs Micrographic Surgery and reconstructions. As well, Dr. Arutyunyan received advanced training in numerous cosmetic procedures such as Botox, Dysport, Fillers (Restylane, Juviderm, Radiesse, Sculptra, Belotero, and many others), platelet-rich-plasma, as well as Lasers.

Shahjahan Shareef, DO

Mohs Surgeon

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Shah Shareef D.O. is a double board-certified dermatologist and fellowship trained Mohs and Cosmetic Surgeon. Dr. Shareef completed an accelerated dual undergraduate-medical degree program at Nova Southeastern University in Fort Lauderdale, FL. Dr. Shareef completed his dermatology residency at OPTI West/Island Dermatology in Newport Beach, CA. Dr. Shareef trained under Dr. Eli Saleeby, a protege of Mohs micrographic surgery's founder, Dr. Frederic E. Mohs. With 3,000+ Mohs cases to his credit, he completed a fellowship involving over a thousand cases and advanced reconstructions. Concurrently, he pursued an American Society of Dermatologic Surgery Cosmetics Fellowship in South Florida with Dr. Eduardo Weiss & Dr. Shino Bay. His training covered a wide array of cosmetic procedures, including Botox®, dermal fillers, scar revision, and more. Dr. Shareef's contributions extend to presenting diverse dermatology topics at national conferences and publishing research in esteemed journals like JAMA Dermatology, BURNS, and Stem Cell Research and Therapy. Dr. Shareef is a member of the American Academy of Dermatology, American Society for Dermatologic Surgery, and American College of Mohs Surgery. Outside of the office, Dr. Shareef enjoys traveling, running, tennis, basketball, music, and food.

Our team

Click the button below to learn more about the rest of our amazing team.

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