At Dermatology Associates Skin & Cancer Center, Dr. Christopher Wolfe, our board-certified dermatologist and fellowship-trained Mohs surgeon, provides the highest level of precision and care in skin cancer treatment. He specializes in and recommends Mohs surgery whenever possible (as opposed to traditional excision surgery) because it’s the most advanced and effective method for removing skin cancer while preserving healthy tissue.
Why Mohs Surgery Stands Apart
1. The Highest Cure Rate Available
Mohs surgery offers up to a 99% cure rate for primary skin cancers — the most effective treatment available today.
2. Complete Margin Evaluation
With Mohs, 100% of the surgical margin is examined under the microscope, ensuring no cancer cells are left behind. In comparison, standard excision evaluates less than 1% of the margin, leaving room for missed cancer cells.
3. Proven Long-Term Results
Only 1 in 100 cases treated with Mohs may recur, versus 1 in 20 with traditional excision. That’s a twentyfold difference in long-term success.
4. See the Whole Story
Excision is like reading 50 pages of a 1,000-page book and trying to tell the whole story. Mohs surgery reads every page, providing the complete picture — and the most thorough removal possible.
Mohs Examines 100% of the Margin — Excision Looks at Less Than 1%
Mohs
During Mohs surgery, Dr. Wolfe removes the visible tumor with a very narrow 1-2 mm margin and carefully flattens the tissue so that all edges and the deep surface lie on a single plane. This allows horizontal sectioning of the tissue under a microscope, ensuring 100% of the surgical margin is examined. If cancer cells are seen anywhere along the edge, Dr. Wolfe maps their exact location and removes only the affected tissue in the next stage. This ensures that no microscopic “roots” of cancer are left behind while sparing healthy skin.
Excision
In an excision, a larger elliptical cut is made around the visible tumor, and the tissue is examined by an outside pathologist. The tissue is sliced vertically, a method often called “bread-loaf” sectioning. Only a few thin slices are checked under the microscope, which represents less than 1% of the total margin. If cancer cells are hiding between those slices, they remain undetected. It’s like reading 50 pages of a 1,000-page book and trying to understand the entire story. Tumor cells in unexamined sections can leave residual cancer behind.
Precision and Tissue Preservation
Mohs
Mohs surgery is performed in stages, allowing Dr. Wolfe to remove and examine one layer at a time. This ensures that only tissue containing cancer is taken out. By sparing as much healthy skin as possible, Mohs offers the highest cure rate with the smallest possible scar, a crucial benefit for cancers on the face, neck, or other cosmetically sensitive areas. The technique’s tissue-sparing precision also reduces the need for later reconstructive procedures.
Excision
In contrast, standard excision surgery removes a predetermined margin of normal tissue around the visible tumor, often much wider than necessary. Since the margins are not analyzed in real time, there is no opportunity to adjust during the procedure itself. While this method can be effective for smaller or low-risk cancers, it can result in unnecessary tissue loss and larger scars, especially in delicate facial areas where precision matters most.
Cure Rates and Recurrence
Mohs
Because Mohs surgery evaluates the entire margin, it offers the highest possible cure rate for skin cancer: up to 99% for primary tumors. Statistically, only approximately 1 in 100 cases may recur after proper Mohs treatment. Each layer is checked immediately during surgery, so the cancer is cleared before you leave the office.
Excision
With a standard excision, only about 0.5% of the total margin is reviewed, and as a result, as many as 1 in 20 cancers can come back. These recurrences often occur months or even years later when undetected cells begin to grow again. Though excisions are common, they lack the precision and long-term success of Mohs surgery.
Expertise Behind The Procedure
Mohs Surgery can only be performed by a Mohs surgeon
Mohs
A fellowship-trained Mohs surgeon like Dr. Wolfe is uniquely qualified to perform every step of the procedure, from removing the cancer to examining it microscopically and then performing the reconstruction. This specialized training teaches the surgeon to identify cancer cells both clinically (on the skin) and microscopically (under a microscope). Dr. Wolfe personally analyzes your tissue in real time, ensuring any remaining cancer is precisely mapped and removed.
Frozen Section Excision “Mohs Mimic”
Occasionally, other surgeons use a procedure called frozen section excision to mimic Mohs surgery when treating cancers on the face, head, and neck. In this process, the surgeon removes the tissue and sends it to an external pathology lab, where a pathologist examines it using vertical “breadloaf” sections. However, this method only allows the pathologist to view less than 1% of the tissue’s margins. If cancer is detected in those limited slices, the pathologist must approximate its location and communicate that back to the surgeon. It’s a bit like driving blindfolded while relying on a passenger to tell you where to turn. While this procedure is completed in a single day, similar to Mohs surgery, its limited margin evaluation leads to a much higher chance of cancer recurrence compared to the precision and thoroughness of Mohs surgery.
Treat it Once, and Treat it Right
If skin cancer isn’t completely removed the first time, it often returns deeper and more aggressively, making future treatment much more challenging. Mohs surgery remains the gold standard for recurrent and complex skin cancers, offering the highest cure rate. By treating it right the first time with Dr. Wolfe, one of only twelve fellowship-trained Mohs surgeons in the entire panhandle of Florida, you minimize the risk of recurrence and avoid more invasive procedures later. The images below illustrate how skin cancers treated with less effective methods can recur more extensively, emphasizing why Mohs surgery is the top-recommended treatment for achieving complete, lasting removal.
Graphic Content Warning. Click to View Image.
Schedule Your Consultation With One of Our Dermatology Providers
Dermatology Associates Skin & Cancer Center is led by Dr. Christopher Wolfe, a double board-certified dermatologist and Mohs surgeon who is one of only twelve fellowship-trained Mohs surgeons in the entire panhandle of Florida and South Alabama. He is also the only Mohs surgeon from Destin to Tallahassee and as far north as Dothan, Alabama that treats early-stage melanoma of the head and neck using a specialized form of Mohs surgery with immunostains. By choosing Mohs surgery, you’re choosing the most precise, tissue-sparing, and effective method for treating skin cancer. Schedule your consultation today and experience expert, compassionate care from a trusted local physician dedicated to your lifelong skin health
