What is Mohs Surgery?
Mohs surgery is a process by which the surgeon takes a certain amount of tissue from your face or your scalp, wherever the cancer exists. He examines that tissue under the microscope to determine whether he has gotten all of the cancer cells. If he has gotten all of the cancer cells, you’re essentially finished. If he has not gotten all of the cancer cells, then you go back into the office – you’ve been sitting in a waiting room for about 20 minutes, you go back, and he takes a little bit more tissue and he examines it all over again to make sure he has gotten all of the cancer cells. If then he has gotten all of the cancer cells, you’re finished and that’s the end of that part of the procedure.
How did you discover you
needed Mohs surgery?
I found out that I needed Mohs surgery many years ago, probably 25 years ago or so. I developed a little red spot on my nose and it wouldn’t go away so I consulted a dermatologist at that time. The dermatologist suggested that I get a biopsy, which I did and it turned out to be basal cell carcinoma. He then recommended, actually I asked him what options I had to remove the basal cell carcinoma and among the options was Mohs surgery which is the least invasive kind of surgery for skin cancer. So I then asked for a recommendation. This was all up north, in New York, and he sent me to the top Mohs surgeon at the time. He was the head of the department at NYU Medical school and that’s where it all began and then I had the Mohs surgery which is very successful.
Please describe your sun exposure history.
My skin history begins when I was a baby. When I was a baby my family took me to a beach called Edgemere, outside of New York City on the Atlantic Ocean and I undoubtedly was exposed to a lot of sunshine then. We didn’t have sunscreen, we didn’t know about covering up to protect ourselves against skin cancer. Then as I grew older, I kept going to the beach because I enjoyed the ocean, riding in the waves and that sort of thing, more and more exposure to sunlight. I went to sea as a merchant seaman in 1947 and got a real bad sunburn with bubbles on my head and that probably contributed again to more skin damage. Over the years, that probably increased as I exposed my skin to the sun. That’s pretty much the history of my exposure.
What is it like working with Dr. Sax?
Working with Dr.Sax is a wonderful experience. He’s patient, he’s considerate. He will discuss the procedure with you at length if you have questions, or if you’re upset he will set you at ease. He has wonderful bedside manner in addition to his terrific skills and that’s a combination that’s hard to resist. During the recovery, you come back to see Dr.Sax for the removal of the sutures and as I recall, that’s about it. If there’s any problem,Dr.Sax says call, immediately come over and he will take another look but I’ve never had a problem post-surgery. I went unequivocally recommend Dr.Sax to other patients A, because he is skilled, even if he did not have good bedside manner, the skills alone would be sufficient to recommend him. But his bedside manner is terrific. He makes you comfortable and you don’t even feel like you’re going to have surgery.
How did you find Dr. Sax?
I choose Dr.Sax first of all, it was a matter of luck. I moved down to Sarasota and was looking for a good dermatologist because I had skin problems in the pats up north and it had been taken care of by the best surgeons in the area. I was driving down University Parkway one day and I saw a sign on the side of the road that said Dr.Sax dermatologist. Very convenient so I figured I would check on Dr.Sax’s credentials. I did that and found out he was extremely well qualified as a mohs surgeon. There’s a process that a surgeon has to go through to become mohs certified. Then I made an appointment with Dr.Sax. He was very happy when I met him. He answered all of my questions. He was very patient and that’s how I found him.
What does Mohs surgery feel like? How long does it take?
The surgery itself is not painful at all. As a matter of fact, you won’t feel anything. You might feel a little bit of pressure but that’s as far as it goes the anesthesia has deadened the whole area and it’s a piece of cake. The surgery itself, takes a matter of minutes. In my experienceit’s usually maybe five minutes. R. Sax is very quick, very accurate and you’re sitting in the chair being operated on for hardly any time at all.
Describe the process of Mohs surgery…
When you arrive at the surgeon’s office, Dr.Sax’s office in my case, you are prepped by an assistant. What does that mean? Your area where the surgery is going to be performed is washed with an antiseptic. You are given a local anesthetic which is a couple of little sticks in the area. That’s the preparation. Then Dr.Sax will come into the office. He’ll greet you and he’s very warm and he’ll ask you if you have any questions and if you do, you ask him and he answers them. After that, he’ll put a covering over the area that he’s going to do the surgery on, which has an opening so he can work inside and then he’ll remove the tumor, the basal cell carcinoma or the squamous cell carcinoma, whatever it happens to be and he will then take the specimen into another room where he will examine it under a microscope. In the meantime, you sit in a waiting room for maybe about 20 or 30 minutes while he’s examining the tissue and that’s about all up to that point.
Was there any scarring?
As far as recovery is concerned it’s a question of a couple of stages. The first stage is like one week from the time of the surgery until the sutures are removed. Now, you have a little red mark, Dr.Sax is an expert at this, I don’t know if he’s certified as plastic surgeon but he should be. You have a little red mark and that will heal over a period of another few weeks or so and then nothing is left. You can see my face. I’ve had a number of mohs surgeries. I defy anybody to find out where they were.
What is the recovery from
Mohs surgery like?
After the surgery is performed and you’re all finished and all the cancer cells are gone, Dr.Sax will apply a bandage. You go home, after that you clean the wound twice a day either with peroxide or water and mild soap, you apply an antibiotic to it, and you put a band aid on it and you do that for approximately five or six days until you go back to the office to have the sutures removes. During that period, there’s virtually no pain. It would be the amount of pain if you scratched yourself or cut yourself or something like that. You can take a mild pain killer like a Tylenol and that’s all you really need.
What is your opinion of Dr. David Sax?
I would tell other patients that if they want to have surgery or they need to have surgery for basal cell carcinoma or squamous cell carcinoma and they don’t want to have any scars and they don’t want to have any pain, then they should go to Dr. Sax because I will guarantee you- well, I better not guarantee you but my experience tells me that you will not have any pain and you will not have any scars.
Case Study provided by Sarasota photographer Steve Schadt