Your Mohs surgery will be done by a fellowship-trained dermatologist with expertise in skin cancer removal, review of microscope slides and surgical reconstruction. Mohs is performed under local anesthesia on an outpatient basis.
Offers the highest cure rate (up to 99 percent)
Has the lowest chance of cancer re-growth
Spares the most normal skin in the tissue removal process
Minimizes the potential for scarring or disfigurement
Is the most exact and precise means of skin cancer removal
Is cost-effective, outpatient surgery utilizing safe local anesthesia
Mohs Micrographic Surgery at The Skin Cancer and Dermatology Institute is performed at our offices in Reno and Carson City. Both are state-of-the art facilities where your entire procedure will occur from cancer removal to repair.
Dr. Kiene, Dr. Rowe, Dr. Hovenic and Dr. Staidle are board-certified dermatologists who have completed intensive fellowship training in Mohs Surgery. Our physicians are the only physicians in Northern Nevada to have completed this fellowship and all are members of the American College of Mohs Surgeons.
Dr Rowe and Dr Kiene completed their fellowships at the University of British Columbia, Dr Hovenic at the University of California, Irvine and Dr. Staidle at the Dermatologic Surgicenter in Philadelphia, PA.
Your doctor feels that your skin cancer will be best treated with Mohs surgery. Mohs surgery is the treatment of choice when:
The cancer is in an area of the body where it is important to preserve healthy tissue for the maximum functional and cosmetic result including cancers on the face, eyelids, nose, ears, and lips
The edges of the cancer cannot be clearly defined
Skin cancer that has recurred, or for which prior treatment has failed or if you have had multiple skin cancers in the past
The cancer is especially aggressive
The cancer is large
You have a deficient immune system, such as kidney or heart transplant patients
You will arrive at the Skin Cancer and Dermatology Institute and be taken to your procedure room. This will be your room for the duration of your appointment. Your appointment may last several hours, depending on the complexity of your skin cancer. We recommend you bring one person with you on the day of treatment who can keep you company and drive you home especially if your cancer is located near your eye area where a patch bandage may be required.
Your skin cancer and the surrounding skin will be numbed with a local anesthetic. The doctor will remove the visible portion of your skin cancer and a draw a map of the removed cancer to be used to guide the precise location of any remaining cancer cells. Your wound will then be bandaged and your skin cancer will be taken to the on-site laboratory. The laboratory portion takes 45minutes to one hour. During this time, a specialized technician will turn the cancer into a microscope slide. The doctor then reviews the slide and determines if there are any cancerous cells remaining. Their location is traced on the map so that only areas with remaining skin cancer undergo further surgery. The process is then repeated until the cancer is cleared.
When the area is determined to be cancer-free, the wound is repaired using advanced reconstruction techniques. In some cases, we may coordinate with a specialist in eye or ear reconstruction who will do your repair.
Do I need to take time off work for my surgery
You will need to be off for the entire day of your surgery, as we cannot predict how long you will be with us on that day. If you do any physical labor at your job, please plan to take off the two days after surgery. We ask that you take it easy for at least 48 hours after surgery to minimize complications such as bleeding or problems with your stitches. We can provide a work note at your visit.
What should I bring with me on day of surgery?
Please bring a book or a tablet (iPad, etc.) to help pass the time. We have Wi-Fi available. Wear comfortable clothes that can be easily removed without going over your head such as a button down shirt. We will provide light snacks throughout the day.
Should I stop my medications before my surgery?
Only stop your medications if instructed by your primary care doctor or cardiologist. If you take aspirin for prevention and have NO history of heart attach or stroke, please stop your aspirin ten days before surgery. If you take ibuprofen or naproxen, please limit your use for two weeks prior to surgery. Please stop the following oral supplements one week prior to surgery- fish oil, garlic supplements, gingko and vitamin E.
Will I need antibiotics prior to surgery?
If you have been told by your doctor to take antibiotics before procedures and you have a history of artificial implants, heart valves, heart murmurs or other conditions, please call our office prior to surgery so we can plan accordingly.
Do I need to fast prior to surgery?
No, please eat breakfast and take your regular medications. You will be awake for the procedure so it is not necessary to fast.
Will I have a follow up visit after surgery?
Usually you will be seen the following week to get your stitches out unless you live far away and we will coordinate having your stitches out closer to home. Often times there is a second visit a month after surgery to check on your healing. Additional visits may be needed and will be made based on your individual needs.
Will I have a scar after my surgery?
Removal of a cancer will always result in a scar. Mohs surgery is used to remove your skin cancer in a tissue sparing manner and our doctors are experts in reconstructive surgery and every effort will be made to make your scar as natural as possible.
640 W. Moana Lane
Reno, NV 89509
3950 G. S. Richards Blvd
Carson City, NV 89703
Whitney Hovenic MD, MPH
Kevin Kiene, MD
Jonathan Staidle MD
Dan Rowe, MD