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Mohs Micrographic Surgery


Named after Frederick mohs, MD,  the innovative surgeon who invented the technique, Mohs Micrographic Surgery is an extremely precise method of removing skin cancers such as Basal Cell Carcinoma and Squamous Cell Carcinomas.


There are two main advantages to Mohs surgery: First, with Mohs surgery we can achieve the highest cure rate of any method of removal, with cure rates of greater than 99%.  Second, because of the method of surgical removal, we are able to leave the patient with the smallest possible defect that will need to be repaired.


On the day of the surgery, you will be brought back to our procedure room.  There, your team will speak with you regarding the Mohs method and answer any remaining questions you have and take photographs of your cancer.  Then, the clinical assistant will get you comfortable and the area will be numbed with a local anesthetic.


After that, the Mohs surgeon will remove the cancer. This part does not hurt at all and only takes a few seconds.  The clinical assistant will get the site bandaged and will escort the patient to the waiting room where we have light snacks and coffee waiting.  It is during this time period that the Mohs surgeon and the Histotechnicians will be processing the tissue sample and making slides for review. The mohs surgeon will then read the slides to examine the margins and see if the cancer is gone.  If there is no more cancer, then the next step will be planning the reconstruction.  If there is cancer left, the Mohs surgeon will bring the patient back from the waiting room and remove another portion of the cancer, only in the area that is needed.  In this way, the Mohs surgeon creates only the smallest, most precise defect that will have to be repaired.


See our video on Mohs surgery, starring our Toledo Mohs surgeon, Dr. David Kouba!


Facial Plastic Reconstruction


Dr. Kouba is the only physican in NW Ohio who is both a fellowship trained Mohs and Reconstructive Surgeon and also a Fellowship trained Cosmetic Surgeon.  In the vast majority of cases, Dr. Kouba will perform the facial plastic reconstruction on the day of your surgery.  In less common instances, he may bring the patient to the operating room to better facilitate the repair.  Sometimes, other specialities will need to be involved in our team.


See our gallery below of facial plastic reconstructions performed by Dr. Kouba on some of our Mohs patients:













after tumor removal



3 months

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