Mohs Micrographic Surgery

Following a 3 year residency in internal medicine and a 3 year residency in Dermatology, Dr. Sky Connolly pursued a fellowship dedicated to Mohs micrographic surgery and facial reconstruction under the direction of Whitney Tope, M.D. at the University of Minnesota. Dr. Connolly is the sole provider of Mohs micrographic surgery at Albuquerque Dermatology Associates & Cutaneous Surgery Center, P.A. The technique, devised by Frederic Mohs in 1937, was created in an effort to reduce the risk of skin cancer recurrence and to minimize tissue loss resulting from the skin cancer removal.

Prior to undergoing Mohs micrographic surgery, the patient will report for a comprehensive consultation appointment with Dr. Connolly to discuss the skin cancer diagnosis, prognosis, surgical and non-surgical treatment options, post Mohs micrographic surgery repair options and benefits and risks for all treatment and repair options. On the day of surgery the patient reports to the clinic in the morning and the site is identified, prepped and anesthetized (numbed) with a local anesthetic injection. Dr. Connolly removes the area believed to represent cancer with a scalpel blade. This tissue is then taken to our on site, state of the art Mohs laboratory, where it will be processed, stained and then examined by Dr. Connolly under the microscope.

The ultimate goal of the microscopic examination is to exam the entire edge and deep surgical margins of the excised specimen. If the tissue examination indicates there is still presence of skin cancer on the patient, Dr. Connolly returns to the patient to remove additional tissue in the direction that has been determined the skin cancer is traveling. Tissue is removed 1 to 2 mm at a time and this process is repeated until tissue margins are clear of skin cancer. Dr. Connolly describes this process as “mining a silver vein until it is empty”. Once all margins are clear and there is no reason to believe that any cancer remains, reconstructive options can then be discussed with the patient.

The surgical procedure mentioned above, as well as the reconstructive options and risks specific to the surgery site are all discussed in detail during the pre-Mohs surgery consultation. These consultations are usually done several days prior to the scheduled surgery appointment. Dr. Connolly has a dedicated staff of surgical assistants that are essential in the operation process, as well as providing important information and support of the postoperative care. They are available to answer patient questions and to schedule the surgical procedures for patients. Our Mohs surgery laboratory is staffed by Shelly and Beth. Both have more than 25 years combined training and experience in Mohs micrographic surgery frozen tissue preparation.