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Mohs Surgery

We are trusted experts in Mohs Surgery procedures & treatment

What is Mohs Surgery?

Mohs Micrographic Surgery is a highly effective technique used to treat skin cancer. Invented by Frederic Mohs in the 1930s at the University of Wisconsin, this treatment allows Mohs surgeons to remove cancerous areas while preserving the maximum amount of healthy tissue possible.

Only certain types of skin cancers and locations on the body are eligible for Mohs surgery. Our dermatologists will work with you to determine if your skin cancer qualifies.

Effective for maintaining healthy tissue

Three in-house Mohs Surgeons

Reassurance & overall peace of mind

DermVA - Medical Dermatology Circle

What makes Mohs Surgery unique?

A Mohs surgeon is uniquely trained as a cancer surgeon, pathologist, and reconstructive surgeon. The Mohs surgery process involves removing the thinnest visible layer of cancerous tissue, one at a time. After the layer is removed, the removed skin is analyzed in a lab to check for any remaining cancer cells. This process is repeated until no more cancerous areas are detected.

The procedure is performed entirely under local anesthesia. You should budget several hours of your time for Mohs surgery in case multiple rounds need to be completed.

Surgery, pathology and reconstruction by one surgeon

Local anesthesia used

Removal of cancerous tissues one layer at a time, usually within the same day

DermVA - Medical Dermatology Circle
DermVA - Mohs Surgery Service Bubble

What are the advantages of Mohs Surgery?

The largest benefit of the Mohs process is that it analyzes 100 percent of the skin under the microscope, resulting in the more accurate analysis. Due to the careful examination involved, the skin cancer treatment rate for Mohs surgery is 98 percent. Immediate surgical reconstruction can be performed after confirming that 100 percent of the cancerous cells have been removed.

Because the surgery process involves removing thin layers of cancerous skin one at a time, the amount of healthy tissue loss is minimized. The aesthetic outcome of Mohs surgery is more optimized compared to other skin cancer treatments due to Mohs being so precise.

The cure rate of Mohs surgery is exceptionally high when compared to other skin cancer surgery options. To explore more options for skin cancer surgery, visit our surgical dermatology page.

The procedure is performed entirely under local anesthesia. You should budget several hours of your time for Mohs surgery in case multiple rounds need to be completed.

98% cancer treatment rate

Healthy tissue maintained

More sophisticated surgical closures

DermVA - Mohs Surgery Service Bubble

Our Mohs Specialists

ASHLEY N. SULLIVAN, M.D., MOHS SURGEON

ASHLEY N. SULLIVAN, M.D., MOHS SURGEON

JULIA K. PADGETT, M.D., MOHS SURGEON

JULIA K. PADGETT, M.D., MOHS SURGEON

NIKOO CHERAGHI, M.D., MOHS SURGEON

NIKOO CHERAGHI, M.D., MOHS SURGEON

Frequently Asked Questions:

What is Mohs Surgery?

Learn more about Mohs Surgery from the Mohs College at: https://www.mohscollege.org/for-patients

How is Mohs surgery different from other surgical dermatology procedures?

Mohs offers the highest cure rate (97-99% for basal cell carcinoma; 97% for squamous cell carcinoma). Other skin cancer treatment methods blindly estimate the amount of tissue to treat, which can result in the unnecessary removal of healthy skin tissue and tumor re-growth if any cancer is missed.

https://www.mohscollege.org/for-patients

When is Mohs surgery recommended?
Traditionally Mohs is offered when the skin cancer is in an area where it is important to preserve healthy tissue for maximum functional and cosmetic result.
How long does a typical Mohs surgery procedure take?

A majority of our patients are done after 2-4 hours. However, every so often a patient may require multiple stages and is with us for the better half of the day so we ask patients to give us the whole day.

Is Mohs surgery performed on an outpatient basis?
Yes, always!
Will I need multiple sessions for Mohs surgery?
The average is 1.7. So most patients require 2 “go at its” or stages. Some however clear in 1 stage; others require 3-4 stages.
What is the success rate of Mohs surgery?

97-99% for basal cell carcinoma; 97% for squamous cell carcinoma

How is Mohs surgery beneficial for cosmetic outcomes?
Location, location, location. Head and neck predominantly, overlying joints or the bony part of the lower legs.
Is Mohs surgery suitable for all types of skin cancer?
Mohs is suitable for non-melanoma skin cancers. For melanomas, the DAV surgeons either perform wide local excision or “slow Mohs”.
What is the recovery process like after Mohs surgery?
All scars take 1 year to fully develop. However, the most improvement is seen in the first 6 weeks following surgery. Pain is normal for the first several days following surgery. Sutures are either removed or dissolve around 1-2 weeks.
Are there risks associated with Mohs surgery?
Pain, bleeding, scar formation, infection, risk of the skin cancer coming back (Mohs provides the lowest risk of this happening but it’s not 0%). Numbness can also occur following surgery but often improves around 2 months.
How can I schedule a Mohs surgery consultation or learn more about the procedure?
When you are a patient at Dermatology Associates, we call you to schedule once your dermatology provider informs the Mohs team. When you are visiting us from an outside dermatology/family medicine practice, you can call 804-939-6191 to speak with one of the dedicated Mohs schedulers.

Ashley N. Sullivan, M.D., Mohs Surgeon

Demo Description


Education:

  • Undergraduate: Boston University, Boston, Massachusetts | B.A. Psychology and Biochemistry & Molecular Biology, 2005
  • Medical School: New York Medical College, Valhalla, New York | M.D., 2011
  • Internship: Medstar Washington Hospital Center, Washington, D.C., 2011-2012
  • Residency: Medical College of Wisconsin Affiliated Hospitals, Milwaukee, Wisconsin, 2012-2015
  • Fellowship: Johns Hopkins Hospital, Baltimore, Maryland | Micrographic Dermatologic Surgery and Cutaneous Oncology (MDSO), 2015-2016

Board Certification:

  • American Board of Dermatology
  • Micrographic Dermatologic Surgery

Location(s):

  • Mohs Surgery Center
  • Top Doc Award 2021 - Richmond Magazine

Q&A:

  • What is your favorite thing about your career?
    Mohs affords me the better half of the day to talk with patients. I am always amazed at how much I learn from them about travel, culture, food, sports…you name it.
  • Would you rather ride a bike, horse, or drive a car?
    Ride a bike!
  • Who is your favorite author?
    William Styron
  • Have you ever had a nickname? What is it?
    Sully (it was given to me before Monsters Inc. came out).
  • What are your hobbies?
    Pinterest-ing.
  • What was the last book you read?
    The Girl on the Train.
  • Are you related or distantly related to anyone famous?
    I am NOT related to Ed Sullivan…I thought we should probably get that question out of the way to have time to get to the good stuff!

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Julia K. Padgett, M.D., Mohs Surgeon

Demo Description


Dermatology Associates of Virginia - Julia K. Padgett, M.D., Mohs Surgeon

Education:

  • Undergraduate: University of North Carolina at Chapel Hill, Chapel Hill. North Carolina | B.S. in Biology, 1990-1994
  • Medical School: University of Virginia School of Medicine, Charlottesville, VA | M.D., 1994-1998
  • Internship: University of Virginia Department of Internal Medicine, Charlottesville, VA, 1998-1999
  • Residency: University of Virginia Department of Dermatology, Charlottesville, VA, 1999-2003
  • Fellowship: University of Virginia Department of Dermatology, Charlottesville, VA | Micrographic Dermatologic Surgery and Cutaneous Oncology (MDSO), 2002

Board Certification:

  • American Board of Dermatology
  • Micrographic Dermatologic Surgery

Location(s):

  • Mohs Surgery Center

Awards:

  • Top Doc Award 2024 - Richmond Magazine
  • Top Doc Award 2022 - Richmond Magazine
  • Top Doc Award 2021 - Richmond Magazine

Q&A:

  • What is your favorite thing about your career?
    I am so honored to have a career that keeps me excited to come to work every day. Mohs surgery is a great combination of surgery, pathology, and reconstruction, each of which I am passionate about. I am blessed to have a fantastic team to help me care for my patients in the best way that I can. There’s nothing else I’d rather do!
  • Would you rather ride a bike, horse, or drive a car?
    Ride a bike! The farther the distance and the higher the hills the better.
  • What’s your favorite type of foreign food?
    I just learned how to make authentic Italian pasta from scratch, along with simple sauces, and my kids and I have a blast preparing this together.
  • What’s your favorite movie?
    The original Star Wars is my favorite, and anything by John Hughes is a close second.
  • What are your hobbies?
    Sports and athletics. We’re an active family, and I love cheering on my kids’ teams. I play squash, I golf with my husband, and I play a little tennis. I really enjoy running and competing in local events.

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Nikoo Cheraghi, M.D., Mohs Surgeon

Demo Description


Dermatology Associates of Virginia - Nikoo Cheraghi, M.D., Mohs Surgeon

Education:

  • Undergraduate: University of Missouri - Kansas City School of Medicine, Kansas City, MS | B.A., 2009
  • Medical School: University of Missouri - Kansas City School of Medicine, Kansas City, MS | M.D., 2013
  • Internship: University of Massachusetts, Worcester, MA, 2013-2014
  • Residency: New York Medical College, New York, NY, 2014-2017
  • Fellowship: University of Minnesota, Minneapolis, MN | Micrographic Surgery and Dermatology Oncology Fellowship, 2017-2018

Board Certification:

  • American Board of Dermatology
  • Micrographic Dermatologic Surgery

Special Interests:

Dr. Nikoo Cheraghi joined Dermatology Associates of Virginia in 2023 following several years of practice in Minnesota. Dr. Cheraghi received her fellowship in micrographic surgery and dermatology oncology at the University of Minnesota. She is board certified in Dermatology with a specialty in Mohs surgery. Dr. Cheraghi is a Fellow in the American Academy of Dermatology, the American College of Mohs Surgery, and the American Society of Dermatologic Surgery.

Location(s):

  • Hanover Office

Awards:

  • Top Doc Award 2024 - Richmond Magazine

Q&A:

  • What is your favorite thing about your career?
    I am so blessed to be a Mohs surgeon for many reasons. There are very few treatments in this world that offer as high cure rates as Mohs surgery does and I am very grateful to be able to provide such a service. My favorite part of what I do is the time I get to spend getting to know my patients and learning about their lives.
  • What is your favorite holiday?
    Thanksgiving is a big deal in my family. I love gathering together and reflecting on being grateful without the pressure of gift giving. And, you can’t forget about the delicious foods!
  • What’s your favorite type of foreign food?
    I’m biased, but my favorite foreign food is Persian food.
  • What are your hobbies?
    My husband and I enjoy traveling and trying new foods from all over the world. I really enjoy learning about where others have traveled so I can plan my next destination. I also love spending time with my cat, Freckles. He’s the cutest.

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