Mohs micrographic surgery
Dr Bashir undertakes Mohs micrographic surgery at The London Clinic (Devonshire place/Harley Street) and at King's College Hospital, London where he leads the Mohs surgery service. Performing about 300 cases per year, he is highly experienced in caring for patients with skin cancers.
A compassionate approach with high level nursing support helps patients through the process. The focus is always on the patient and their family, to help them through the surgery and aftercare to provide excellent cosmetic results and patient satisfaction.
Dr Bashir is a true expert in Mohs micrographic surgery, having trained in a fellowship programme at the prestigious St. John's Institute of Dermatology, St. Thomas' Hospital, London. He has experience in both removing skin tumours by the Mohs method and performing reconstructive surgery to repair facial appearance. Procedures involving the face, eyelids, scalp, nose and ears, whilst highly complex, are routine to our practice.
What is Mohs surgery?
Mohs surgery is a special method used to treat skin cancer. It was developed in the United States and is now becoming available in a limited number of locations in the UK. The benefit of this method is that it minimizes the amount of skin removed whilst maximizing the chance of successfully removing of the growth.
How is it performed?
The procedure is performed under local anaesthetic - the patient is awake and kept comfortable throughout. The dermatological surgeon removes the skin cancer, which is immediately frozen and processed by highly skilled technicians. Within 20-30 minutes, the specimen can be analysed. If there is evidence that there is still cancer left behind, the surgeon removes more, taking only very fine slices of skin, and the processing is repeated. This process is repeated until the tumour has been fully removed.
How long does it take?
The whole process depends on the size of the skin cancer. In many cases, we are able to clear the tumour at the very first attempt, but in other cases, more attempts may be required. The important thing is that the tumour is completely removed by the end of the procedure. We advise patients to allow a full morning to clear the skin cancer and perform reconstruction.
What is a fellowship-trained Mohs surgeon?
Dr Bashir is a fully qualified fellowship trained Mohs surgeon. This means that, in addition to lengthy training in medicine, dermatology and dermatolgical surgery, he as completed a 1-year fellowship specifically deisgned to train mohs surgeons in the surgical skills to perform mohs surgery and to undertake reconstructive surgery. Having completed this fellowship, Dr Bashir has led the Mohs surgery service at King's College Hospital since 2008 and performs the Mohs procedure approximately 6-8 times/week. He is experienced in reconstructing skin at awkward sites, including the eyelids, ears, nose, lips, face, scalp and other body sites. Occasionally, if specialist plastic, occuloplastic, ENT or maxillo-facial reconstruction is required, he can refer you to the appropriate surgeon for reconstruction.
Will I tolerate the surgery?
Almost all patients can tolerate Mohs surgery under local anaesthetic. The nurses are highly caring and skilled at creating a relaxed atmosphere. If you have any particular concerns or needs, these can be addressed at your initial consultation.
Patients are welcomed to the MITU day surgery unit at the London Clinic and are made comfortable. Refreshments and light snacks are readily available and a special lounge area with television and news papers helps you and your companion pass the time while awaiting results.
How will the scar look?
In almost all cases, we are able to provide excellent results, even with large skin cancers. We take a pride in the aesthetic appearance of our work and will make every effort to hide and minimize scars. We also have a suite of lasers available to modify scars if required. If you are being referred by an ENT, plastic or maxillo-facial surgeon, we can coordinate your treatment so that your referring surgeon can perform the reconstruction for you.
Will I need time off work?
We advise most patients to take a few days off work or to work from home if they are able to. This depends on the site of the skin cancer - for example an eyelid skin cancer, once removed and reconstructed, may require and eye patch for a few days. Detailed instructions and advice will be tailored to suit your needs at your consultation.
What support systems do you have?
Patients are well supported by our clinical nurse specialist who will guide you through the process and help you with any recovery questions that you may have. If required, we can put patients in touch with psychological support services too.