Reconstruction surgery is required after any Mohs Surgery procedure.
Dr. Bryce Cowan says that typically the wounds will take over a year to completely heal after the surgery. 10% per month is a typical rate of healing, with the peak at around 2 months.
Scarring can be expected, and if the surgery is in an area where there is function like the legs, patients should be cautious with activities like running that may move the area too much. Plastic surgeons also know that the surgical wounds typically flatten out as the skin starts to stretch, and take this process into account during reconstruction by creating a mound. This can be shocking to the patient as they may expect the site to be flat, but this is actually a way to balance out the flattening that is expected to occur months after the procedure. Redness and numbness at the surgical site is also common and should be expected for some time following the surgery.
Another concern is the wait times. As Mohs surgery is such a specialized procedure, and the number of surgeons that are certified to perform the procedure is small, is the number of clinics that have the tools and trained staff required, this can translate into longer wait times for patients. In countries with longer wait times, typically the cases are triaged, meaning that cases are compared to each other and put on a priority order depending on how urgent the need for treatment is. Quite often, doctors will refer their patient’s cases to a Mohs surgeon, and patients will not have direct access to the surgeon until the time of the procedure. In these cases, it’s very important that they communicate and address concerns like how their cancer is progressing and other questions that they may have with the doctor that is referring the patient.
In terms of the cost of surgery, in Canada the cost of Mohs Surgery is typically covered by the provincial health care plans. In other countries the cost of surgery is often covered by extended health care plans. The type of cancer, the extent of surgery required, and the facility that it’s performed in are some of the considerations that may affect coverage or pricing. These are things that need to be communicated prior to the surgery with the surgeon.
See our subsequent videos for treatment options, the pros and cons in considering the various modalities.