Micrographic surgery is a very specialized way of treating skin cancers. It provides the highest possible cure rate while removing as little normal skin as possible. Micrographic surgery is also called Mohs surgery in honor of Dr. Frederic Mohs who developed the technique.
The procedure begins by thoroughly numbing the area with a local anesthetic. Then all visible cancer is removed and a very thin layer of surrounding skin is taken to check for any remaining cancer cells that are otherwise invisible to the naked eye. This layer is processed by a technician and examined under the microscope by Dr. Romine. The location of any remaining cancer is carefully mapped on a diagram of the surgical wound and then removed in a thin layer. This tissue is also examined under the microscope and the process is repeated as often as necessary until all the cancer cells have been completely removed.
By using these detailed mapping techniques and complete microscopic margin control, Dr. Romine is able to locate and remove even the smallest microscopic cancer roots without sacrificing large and unnecessary amounts of normal, uninvolved skin.
What are my chances for cure?
Micrographic surgery offers the highest available cure rate of all skin cancer treatments. Over 96% of skin cancers are cured following micrographic surgery even if other forms of treatment have failed. Other methods of treatment average only a 60% cure rate if previous treatments have failed.
Will I be hospitalized?
No. Micrographic surgery is performed in an outpatient surgical suite and you may return home the same day.
What happens the day of the surgery?
Your appointment will be scheduled early in the morning or just after noon. Our staff will escort you into a surgical suite where the area around the skin cancer will be numbed. Once it is numb, the visible cancer and a thin layer of tissue will be removed. This tissue is carefully mapped and coded by Dr. Romine and taken to the adjoining laboratory where the technician processes the microscope slides. You will have a temporary dressing placed over the wound during the period of waiting.
The surgical procedure takes only 10-15 minutes. However, it takes a minimum of 1-2 hours in the laboratory to process and examine the tissue. If remaining cancer is found you will be brought back to the surgical suite and a second thin layer will be taken from that area. This will also be taken to the laboratory for processing while you wait. Although there is no way to tell before surgery how many stages will be needed, most cancers are removed in three stages or less.
The hardest part of the procedure is waiting for the results from the laboratory. We would like to make the time you spend with us as pleasant and comfortable as possible. You may want to bring reading material to occupy your time. Magazines, snacks and beverages will be available near the waiting room area. If your visit extends through the lunch hour, your companion may visit a nearby restaurant and bring you a snack or lunch since you are asked not to leave the waiting area until all surgical procedures are completed.
Since we do not know in advance how much time will be needed to remove the cancer and repair the wound, we ask that you make no other commitments for the entire day that you are scheduled for surgery.
Will the surgery leave a scar?
Yes. Any form of skin cancer treatment will leave a scar. However, because micrographic surgery removes as little normal tissue as possible, scarring is minimized. After the cancer is removed, Dr. Romine may choose to (1) let the wound heal by itself, (2) repair the wound with stitches, or (3) reconstruct the wound with a skin graft or flap. This decision is based on the safest method that will provide the best cosmetic result.
Will I have pain after surgery? Most patients do not complain of significant pain. If there is any discomfort, Tylenol is usually adequate for relief. Avoid taking medications that contain aspirin as they may cause bleeding.
Preparing For Surgery
A day or two before your appointment, please complete the attached medical history form and bring it with you the day of surgery.
Continue any medications prescribed by your doctor. Aspirin however is a drug that may prolong bleeding. We ask that you avoid aspirin (including Anacin, Bufferin, Excederin, Alka Seltzer and Percodan) for at least 10 days prior to surgery. Also avoid Vitamin E and Non steroidal anti-inflamitory drugs (ibuprofen, Motrin, Advil Celebrex, Aleve, Bextra, etc.) for five days. If your doctor has prescribed any of these medications for you, please contact his/her office to be sure it is safe for you to stop taking them in preparation for surgery. You may take Tylenol any time before surgery, if needed for pain.
If you are taking blood thinners (Coumadin), please notify our office before your scheduled surgery.
In addition, alcohol will also increase bleeding, so avoid alcoholic beverages for at least 24 hours before surgery, as well as 48 hours after surgery.
Do not wear any cosmetics or perfume when scheduled for a check-up or facial surgery.
Only local anesthesia will be used during the procedure. Most patients are able to drive themselves to and from the surgery with no difficulty.
The day of surgery, we suggest that you eat a normal meal just prior to your scheduled appointment.
Please plan to arrive fifteen minutes early so that we may complete your medical record and obtain necessary insurance information.
Micrographic surgery is covered by all major insurance carriers. We also accept assignment on Medicare. This means that we agree to accept their approved fee as payment, however please remember that Medicare only pays 80% of their approved fee; you or your secondary insurance carrier is responsible for the remaining 20%.
We will submit a claim to your insurance company for you. Please bring any necessary insurance information (including the mailing address of your insurance company) with you to your visit. You will also be responsible for any deductibles or co-payments required by your insurance.
Please contact your insurance company before surgery to check if prior authorization is required.
If you have any additional questions, please call us at (602) 954-7546.
Here’s What Our Patients Have To Say...
"I was referred to Dr. Romine for MOHS surgery to remove a basal cell carcinoma. First time so I had no idea what to expect. The staff were all excellent, reassuring, compassionate, caring, cheerful, and kind. Dr. Romine was likewise and I found her to be extremely efficient, talented, gentle, and spent time answering my questions. In addition, I believe that her level of skill has completely minimized what could have been an ugly scar on my cheek. I highly recommend Dr. Romine, her staff, and the overall level of care and support I experienced."
"I was referred to Dr Romine by a friend who is a nurse; can't say enough good about her...my skin cancer surgery was done so professionally, I never had a nervous moment. I required 8 stitches in my forehead which even the DR could not find on my recheck 6 weeks later: she did such an awesome job! The entire staff is friendly, kind, and easy to work with."
"The place is beautiful and peaceful! I came to support my friend on his surgery today. The service is very professional . The doctor even allowed me to be in the same room wile she was doing the surgery . I was able to be close to my friend all the time. He is afraid of blood , needles and being there helped him to relax. While waiting on the waiting room after the cut , they offered tea, coffee and some snacks."
"Very professional staff! From the time I came in , got very professional service . The building is clean , nice and a peaceful music is going along the building and helps to relax . Surgery always is hard for me, but with the professional service this place provides keeps my heart in peace!"
"I have been a patient of Dr. Romine for many years and would highly recommend her and her office to anyone looking for a great dermatologist. If your looking for thorough, knowledgeable and compassionate look no further Dr. Romine is the real deal. Dr. Romine has done several surgeries on me, all which have healed beautifully and I couldn't be happier. I have seen Dr. Romine's PA's on several occasions whom are also very attentive and received the same excellent care I always receive from Dr. Romine. I have referred friends, family and coworkers to Camelback Dermatology who are also very pleased with the quality care they receive on there exams and skin services. So, If your looking for a caring and knowledgeable office, look no further this is definitely it!"