At Wood MediSpa, we provide a world-class Mohs micrographic surgery service. This specialised procedure offers the highest cure rate of any skin cancer treatment while preserving the maximum amount of healthy tissue. Led by Dr Toby Nelson, a fellowship-trained Consultant Dermatologist and one of only a handful of UK surgeons accredited by the American College of Mohs Surgery (ACMS), our clinic offers a level of precision and expertise rarely found outside of major metropolitan teaching hospitals.
Named after its developer, Dr Frederic Mohs, this technique is a highly specialised surgical method for removing skin cancer, primarily Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC).
Unlike standard surgical excision, where a surgeon removes the visible tumour plus a wide safety margin of healthy skin and sends it to a lab for results days later, Mohs surgery involves the immediate microscopic examination of 100% of the surgical margins while the patient is still in the clinic.
The Gold Standard in Skin Cancer Treatment
The core advantages of this approach include:
- Unrivalled Cure Rates: Mohs surgery boasts a success rate of up to 99% for new skin cancers and 95% for recurrent tumours.
- Maximum Tissue Conservation: By precisely mapping the roots of the cancer, Dr Nelson only removes the diseased tissue, leaving healthy skin untouched.
- Superior Aesthetic Results: Because the resulting wound is as small as possible, the subsequent reconstruction can be more refined, which is vital for the face.
The Mohs Procedure: A Step-by-Step Guide
The journey at Wood MediSpa is designed to be as comfortable and stress-free as possible. The surgery is performed as an outpatient procedure under local anaesthetic, meaning you remain awake but will not feel any pain in the treated area.
Step 1: The Initial Removal (The First Stage)
After the area is numbed, Dr Nelson removes the visible portion of the skin cancer along with a very thin layer of surrounding tissue. This tissue is carefully mapped and colour-coded to ensure its exact orientation on your body is preserved.
Step 2: On-Site Laboratory Analysis
The removed tissue is taken immediately to our onsite histology laboratory. While you relax in our private patient lounge with refreshments, our specialized technicians freeze and slice the tissue into paper-thin sections. These are stained and placed on slides for Dr Nelson to examine under a microscope.
Step 3: Microscopic Mapping
Dr Nelson examines 100% of the edges and the underside of the tissue. If he detects even a single cancer cell at the margin, he uses the map created in Step 1 to identify exactly where that cell is located on your skin.
Step 4: Targeted Removal (The Second Stage)
If cancer remains, Dr Nelson returns to the surgical site to remove another thin layer – but only from the specific area where the cancer roots were found. This process is repeated in stages until the entire margin is microscopically confirmed to be cancer-free.
Step 5: Reconstruction
Once clearance is achieved, Dr Nelson focuses on the aesthetic restoration. Depending on the size and location of the wound, this may involve a simple closure, a skin flap (moving nearby skin to cover the gap), or a skin graft.
Why Precision Matters: The Iceberg Effect
Skin cancer is often like an iceberg; what you see on the surface may only be the ‘tip’. Underneath, silent roots or ‘fingers’ of cancer can spread out into the surrounding skin, following nerves or blood vessels.
Standard surgery often misses these roots because a pathologist typically only examines about 1% of the margin (the bread-loafing technique). If a root happens to fall between the slices, the cancer is left behind, leading to a recurrence. Mohs surgery eliminates this guesswork by examining every millimetre of the margin, ensuring nothing is missed.
Is Mohs Surgery Right for You?
While Mohs is the gold standard, it is typically reserved for specific cases where its precision is most beneficial:
- High-Risk Locations: Cancers on the nose, eyelids, lips, ears, and scalp, where preserving skin is essential for both function (such as breathing or blinking) and appearance.
- Recurrent Cancers: Tumours that have returned after previous treatments.
- Aggressive Subtypes: Cancers that are known to grow quickly or have poorly defined borders that make them difficult to see with the naked eye.
- Large Tumours: Cancers that have grown to a significant size where standard wide margins would be disfiguring.
The Wood MediSpa Experience
Choosing Wood MediSpa means receiving world-class medical care in the peaceful, private setting of a 30-acre Devon estate with full hospital-grade facilities.
- Fellowship-Trained Expertise: Dr Toby Nelson is an international expert who leads Mohs training for other consultants. His dual expertise in both the surgery and the microscopic analysis (pathology) ensures the highest level of continuity.
- Onsite Histology Lab: Having our own lab means you get results in real-time, often completing the entire process in a single day.
- Bespoke Aftercare: We provide detailed post-operative instructions and a direct line of contact for any concerns during your recovery. For patients travelling from afar, we can even offer overnight stays in our luxurious hospital rooms.
- Collaborative Care: We offer a multidisciplinary approach, ensuring that your skin health is managed comprehensively before and after surgery.
Preparing for Your Surgery
Mohs surgery is a day-case procedure. Because we cannot predict how many stages will be required to clear the cancer, we ask that you prepare to spend the majority of the day with us. Most cases are cleared in one or two stages, but we prioritise thoroughness over speed to ensure the best possible outcome.
We recommend wearing comfortable clothing, bringing a book or tablet, and arranging for someone to drive you home. Our team will provide you with a light lunch and refreshments throughout your stay.
Skin cancer can be a frightening diagnosis, but Mohs micrographic surgery offers the most reliable path to a cure with the least impact on your natural appearance. By combining the surgical precision of Dr Toby Nelson with the advanced facilities at Wood MediSpa, we ensure you receive the very best in modern dermatological surgery. Our team works with all major private medical insurers to ensure your journey to healthier skin is as seamless as possible.
If you are considering Mohs surgery, please call us on 01837 516629 or alternatively use the contact form below.