Mohs Surgery

Mohs Surgery

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.

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.

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 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

Dr. Allan Harrington

Dr. Allan Harrington

Medical Director & Mohs Surgeon

Dr. Allan Harrington is one of OnSpot's many medical directors who has devoted his professional career to the treatment of skin cancer. Dr. Harrington is the former Director of Skin Cancer Surgery at Walter Reed Army Medical Center and assistant professor at John Hopkins Medical Center. He has performed more than 80,000 Mohs surgeries during his career.  Mohs surgery is the most common procedure to treat skin cancer and OnSpot is lucky to follow the direction and leadership of Dr. Harrington when it comes to treating our patients that have skin cancer.

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Dr. Andrew Styperek

Medical Director & Mohs Surgeon

Dr. Andrew Styperek is a fellowship trained, board-certified dermatologist. He graduated from Harvard University with a bachelors degree in business. Dr Styperek then went on to Emory University School of Medicine in Atlanta, GA. His residency trained was completed at University of Miami School of Medicine, where he was also chief resident for a year. After his residency he underwent advanced training at Houston Methodist Hospital under the instruction of Dr. Leonard Goldberg. It was there where he completed an extensive fellowship program including skin cancer diagnosis and treatment, cosmetic and anti-aging treatments and venous disease management. He is now working for OnSpot as a Mohs surgeon.

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Dr. Richard Levine

Mohs Surgeon

Dr. Levine graduated cum laude with a degree in biology from the University of Western Ontario. He went to University of Western Ontario for medical school and then completed two years of internal medicine residency training at the University of Toronto. Dr. Levine also did  research  in  wound  healing at the University of Miami and published several peer reviewed journal articles presented at national meetings. He completed his residency in Dermatology at McGiII University in 1997. With extensive post residency training thereafter, he became a Fellow of The American Society For Mohs Surgery and Fellow of The American Academy of Cosmetic Surgery. Dr Levine is a Fellow of The American Board of Mohs Surgery.

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Liz Sandoval

Mohs Lead Medical Assistant

Liz Sandoval is a talented medical assistant who graduated from Southern Technical College in Port Charlotte with an Associates of Science as a surgical technologist. She previously worked at ADCS in Cape Coral as a surgical technician, and was later promoted to a surgical coordinator. She is currently working as our dedicated Mohs Lead Medical Assistant. Liz has assisted in over 1,000 Mohs cases & excisions (the removal of skin cancers) while leading and training a team of technicians & scheduling surgical appointments. Liz has previously worked under other one Mohs surgeons & excited to now be working with 2 incredible Mohs surgeons with OnSpot. She is incredibly passionate about her career at OnSpot and providing the best possible care for our patients.