Mohs Micrographic Surgery


Skin cancers can sometimes be more pervasive under the skin than they look from the surface. Skin cancer can have “roots” along blood vessels, cartilage, nerves, or the skin.  Mohs micrographic surgery has been precisely designed to methodically track and remove these cancerous “roots.” It is recognized as the skin cancer treatment with the highest noted cure rate.

Before the development of Mohs Surgery in 1930, by Dr. Fredric Mohs at the University of Wisconsin, surgeons were unable to accurately predict how much skin had to be removed in order to completely eliminate all the cancer. With Mohs, the cancerous tissue is not only entirely removed, but the normal, healthy tissue is saved.

Although Mohs surgery can offer great results, it is not suitable for treating every skin cancer.  Mohs is intended for people who have skin cancer with a high chance of recurring, or patients whose cancer has recurred despite previous treatment. Mohs is also used for treating cancer on the nose, lips, eyelids, ears, hands, feet, hairline, and genitals.  In these cases, it is crucial to conserve as much healthy skin as possible, in order to achieve optimal cosmetic results or functional purposes.

If you think you’re a good candidate for Mohs Micrographic Surgery, please read the following guide.  It provides you with the fundamentals and gives you an accurate portrayal of what to expect from having your surgery performed by Dr. Sachse.

Dr. Sachse understands that each patient’s situation is unique and that every procedure must be tailored to fit the specific needs and goals of the patient.  Dr. Sachse works with each patient, making sure that they are completely informed about every aspect involved in the procedure, and what results can be expected.

Here at Broward Plastic Surgery, Dr. Sachse and his staff are dedicated to providing patients with the highest quality medical and personal care.  Each aspect of patient care, from the first consultation to the last visit, receives the same careful consideration. We are available Monday through Friday, 9am-5pm to help answer questions or concerns.  Dr. Sachse is available to all of his patients 24 hours a day, 7 days a week.


Prior to Surgery

During your initial consultation, Dr. Sachse will review your complete medical history, as well as any medications you may be taking (including vitamins or herbs), any allergies you may have, and your alcohol and tobacco use. Be sure to provide him with every bit of information, as this prevents complications and will help Dr. Sachse give you the best results. Dr. Sachse will also want to discuss the motivating factor behind the procedure, your priorities, concerns, and fears.  He will make suggestions, explain the advantages and disadvantages of every option, and advise you on the best choice, given your desired appearance.

Where Your Procedure Will Be Performed and Anesthesia

Mohs surgery can be performed in a hospital or C.L.I.A licensed facility. To ensure your comfort during the procedure, general anesthetic will be administered, using local anesthesia.

The Procedure

The treatment area is properly cleaned and marked, and a local anesthetic is injected. Dr. Sachse will remove the visible cancer and also an additional thin layer of tissue. The wound will be sutured closed, or a skin graft or skin flap may be used in cases where there is not enough tissue to cover the wound.  For the skin flap, skin adjacent to the treated area is cut, rotated, and moved to cover the wound.  Stitches are used to hold the flap in place. A skin graft uses skin from the neck, collarbone, or behind the ear to cover the wound.  Stitches are used to hold the skin graft in place.

The process takes only a few minutes, and the removed cancer is quickly processed and examined while you wait.

Following Your Procedure

Usually, Mohs surgery is performed as an outpatient procedure. The patient is awake for the duration of the procedure and typically experiences minimal discomfort. Dr. Sachse will monitor your pain, and medications will be prescribed if needed. There may be swelling and bruising around the treatment area, particularly occurring when surgeries are near the eye area. Dr. Sachse will give you specific, detailed instructions on how to care for your wound following surgery.

Once Dr. Sachse has removed the cancerous skin, you will either allow the wound to heal naturally, have Dr. Sachse repair the wound to achieve an improved appearance, or return to your physician for wound repair.

What to Expect


After the skin cancer has been removed and the wound has completely healed, the smallest possible scar will remain. Often, a wound that heals on its own leaves scars that are hardly noticeable. Scars flatten and improve over the first twelve months following surgery.  If patients are not satisfied with the way their scars have healed, Dr. Sachse has the option of using a dermal filler to lift indented scars. If scars are raised or rough, chemical peels and laser-resurfacing techniques can be used. Patients who have skin flaps or skin grafts may need a “touch-up” procedure to improve their appearance.


For further information on Mohs Micrographic Surgery, please call Broward Plastic Surgery at 954-202-9898