Mohs Surgery

Dr. Farhadian completed a fellowship in Mohs micrographic surgery and dermatologic oncology at Yale School of Medicine, where he remains on faculty. He has performed over 3,000 Mohs micrographic surgeries.

Mohs micrographic surgery was developed in 1938 by Dr. Frederic E. Mohs. Over the years, it has been refined and modified into its current form. Today, Mohs surgery is the most advanced and effective treatment for a variety of skin cancer types.

Mohs surgery is an outpatient procedure performed under local anesthesia. On the day of surgery, the surgical site is anesthetized and the skin cancer is removed with a narrow margin of normal skin. The tissue is then brought to the on-site laboratory where it is processed and evaluated under the microscope by Dr. Farhadian. If residual skin cancer is noted at any margin, then additional tissue is removed from the area where skin cancer is still present. This tissue is again processed and evaluated for residual tumor. If skin cancer is still present at the margin, then additional tissue is removed from the affected area. This process is repeated until the entire skin cancer is removed.

Once the margins are clear, reconstruction may be performed. In some cases, the wound will heal naturally. In other cases, the wound will be sutured into a straight or curved line. Sometimes, a more advanced procedure such as a skin flap or skin graft is needed to repair the defect. The choice of reconstruction is generally based on several factors including the size and location of the wound, the quality of the surrounding tissue, smoking status, and patient goals of care.