Manchester has plenty of private skin clinics. It has very few surgeons who perform Mohs micrographic surgery, and fewer still who also carry out the facial reconstruction that follows. Miss Rakhee Nayar does both. She is a Consultant Plastic Surgeon and Mohs surgeon, one of fewer than ten women in the UK dual-trained in both disciplines.
Manchester patients are seen at Circle Cheshire Clinic in Wincham, near Northwich, roughly thirty-five minutes out along the M56.
Why Mohs, and why one surgeon
Mohs surgery removes a skin cancer in thin layers, examining each under the microscope while you wait, so the surgeon knows the margins are clear before stopping. It gives the highest cure rates for basal cell and squamous cell carcinoma and takes the least healthy tissue — which is exactly what you want on a face.
The second half matters just as much. In many pathways the reconstruction is handed to a different surgeon, sometimes weeks later. Here the person who removed the cancer plans the repair, whether that is a local flap, a nasolabial flap, a skin graft or, for larger nasal defects, a forehead flap.
Getting to the clinic from Manchester
Circle Cheshire Clinic is at The Courtyard, Hall Lane, Wincham, Northwich CW9 6DG. From central and south Manchester the route is the M56 westbound to junction 10, then south on the A559 towards Northwich. Around thirty-five minutes outside rush hour, and considerably easier than crossing the city.
Free patient parking on site — a genuine advantage over central Manchester clinics when a Mohs appointment can run to half a day. The route suits Didsbury, Chorlton, Sale, Stretford, Wythenshawe and the south Manchester suburbs.
Mole, cyst and skin lesion removal
Benign lesions are also removed at the clinic: moles, cysts, skin tags, lipomas, lip lesions and split earlobe repair. Everything removed is sent for analysis. See skin lesion removal.
A note on dermatology
Miss Nayar is on the GMC specialist register for Plastic Surgery. She is not a dermatologist, and does not treat acne, eczema, psoriasis or rosacea. If you need a skin condition diagnosed, a dermatologist is the right specialist. If you have a confirmed skin cancer on the face that needs removing and rebuilding, this is the relevant expertise.
Common questions
Is there a Manchester clinic? No. All consultations and surgery take place at Circle Cheshire in Northwich, about thirty-five minutes from south Manchester.
Can I start with a remote consultation? Yes. An e-consultation allows a first assessment of a lesion before you travel, and is often the sensible first step for Manchester patients.
What about follow-up? Wound checks and suture removal are done at the Northwich clinic. The schedule is set out before surgery so you can plan the journeys.
Which skin cancers are treated
Mohs is used mainly for basal cell carcinoma, the most common skin cancer in the UK, and for squamous cell carcinoma. For a previously untreated basal cell carcinoma, cure rates reach up to 99%. Melanoma is managed on a different pathway and is not treated by Mohs surgery here.
Do I need a referral to be seen?
No. You can book a private consultation directly. Most patients do arrive with a GP referral letter and it helps, because it usually carries the reason for concern and any relevant history, but it is not a requirement. If a lesion has already been biopsied elsewhere, bring the histology report. It changes what gets planned.
How long does Mohs surgery take?
Allow most of a day. Removing each layer takes around thirty minutes, but the layer then has to be processed and read under the microscope, which takes roughly an hour. Most cancers are clear after one or two layers. The waiting between layers is the bulk of the day and you spend it in the clinic rather than in theatre, so bring something to read.
Can the cancer be removed and the wound repaired on the same day?
For most patients, yes, and it is the main practical reason to see a surgeon trained in both. Once the margins are confirmed clear, the reconstruction is carried out in the same visit. Where a defect is large, or where a forehead flap is planned, the repair is staged across more than one appointment. That is a clinical decision rather than a scheduling one, and it is explained before you agree to anything.
Is Mohs always the right operation?
No. Mohs is the better choice on the face, ears, nose, eyelids and lips, for tumours with unclear edges, for cancers that have come back, and wherever preserving tissue matters. A small, well-defined basal cell carcinoma on the back or shoulder is usually treated perfectly well by standard excision, in less time and at lower cost. If standard excision is the sensible option, that is what will be recommended.
What happens at the first appointment?
The lesion is examined, usually with dermoscopy, and the history taken. If the diagnosis is already confirmed, the conversation moves to how the cancer would be removed and repaired, where the scar would fall, and how it is likely to settle. If it is not confirmed, a biopsy is arranged first. You leave knowing what is proposed, what the alternatives are, and what it will cost.
Insurance and self-pay
Both insured and self-paying patients are seen. If you are using private medical insurance, check with your insurer before the appointment that Miss Nayar is recognised on your policy, and ask what your cover includes, as you may be responsible for any shortfall. See insurance and self-pay.
Book a consultation
Consultations for Manchester patients are usually available within days, not weeks, at Circle Cheshire near Northwich. Bring your referral letter or biopsy result if you have one.