Mohs Surgeon in Liverpool | Skin Cancer Specialist

Miss Rakhee Nayar’s connection to Liverpool is not incidental. She qualified MBChB with Honours at the University of Liverpool, took her MD in Cancer Studies there, and works as a Consultant Plastic Surgeon within Mersey and West Lancashire Teaching Hospitals NHS Trust. Her private Mohs practice is at Circle Cheshire Clinic in Wincham, near Northwich.

She is a Consultant Plastic Surgeon and Consultant Mohs Surgeon, one of fewer than ten women in the UK dual-trained in both, which means skin cancer removal and facial reconstruction are carried out by the same consultant rather than split between two.

Mohs surgery for Merseyside patients

Mohs micrographic surgery removes a skin cancer layer by layer, mapping and examining each one under the microscope before deciding whether to take more. It produces the highest cure rates for basal cell and squamous cell carcinoma while sparing the maximum amount of healthy tissue — the single most important factor in how the face looks afterwards.

Once clear margins are confirmed, the reconstruction is planned and performed in the same visit wherever possible.

Getting to the clinic from Liverpool

Circle Cheshire Clinic is at The Courtyard, Hall Lane, Wincham, Northwich CW9 6DG. From Liverpool the usual route is the M62 and M6 southbound, or across on the A5300 and M56, leaving at junction 10 for the A559. Allow around forty-five minutes.

Free patient parking on site. The route works equally for Widnes, Runcorn, Halewood, Speke, Woolton and the wider south Liverpool area.

Also seen closer to Merseyside

Miss Nayar also consults at St Helens Hospital and Fairfield Independent Hospital, both considerably closer to Liverpool than Northwich. Her main private Mohs list is at Circle Cheshire, so please ask when booking which is appropriate for your case.

Mole, cyst and skin lesion removal

Benign lesions are removed alongside cancer work: moles, cysts, skin tags, lipomas and lip lesions, all sent for analysis. See skin lesion removal.

Credentials

• MBChB with Honours, University of Liverpool; MD in Cancer Studies, University of Liverpool.
• FRCS (Plast), Royal College of Surgeons of Edinburgh.
• Consultant Plastic Surgeon, Mersey and West Lancashire Teaching Hospitals NHS Trust, and her trust’s specialty training lead.
• National Chairwoman for Mohs training within the Training Interface Group.
• Mohs fellowship representative for BAPRAS.

Common questions

I am under an NHS team in Liverpool. Can I get a private second opinion? Yes, and it will not affect your NHS treatment. Bring your letters and biopsy results and the surgical plan will be reviewed with you.

Can I be assessed before travelling? An e-consultation allows an initial remote assessment, which many Liverpool patients use as a first step.

Is Mohs available on the NHS? It is, in certain circumstances and at certain centres, though waiting times and access vary. Private surgery is a matter of choice and timing rather than of quality of technique.

Which cancers Mohs is used for

Most of this work is basal cell carcinoma, the commonest skin cancer in the UK, and squamous cell carcinoma. Cure rates for a basal cell carcinoma that has not been treated before reach up to 99%. Melanoma is managed on a separate pathway and is not treated by Mohs surgery.

Does it hurt?

The surgery is done under local anaesthetic, so you stay awake and feel nothing once the area is numb. The injection stings for a few seconds. Most people find the length of the day harder than the procedure itself. Afterwards the discomfort is usually mild and settles with paracetamol.

How long does recovery take?

Sutures usually come out between five and fourteen days, sooner on the face than elsewhere. Bruising and swelling peak around the second or third day and settle over a fortnight. A flap or graft takes longer to look settled than a straight closure, and the scar carries on changing for a year or more after that.

What will the scar look like?

It depends on where the cancer is, how much tissue has to come out, and how the wound is repaired. Scars are placed in natural creases and along tension lines wherever the anatomy allows. At three months a scar often looks worse than it eventually will, because most continue to soften and pale for twelve to eighteen months. The options are set out in reconstruction after Mohs surgery.

How soon can I be seen?

Private appointments are usually available within days rather than weeks, which is the main reason patients with a confirmed diagnosis choose to go privately. If a lesion is changing quickly, say so when you book.

Insurance and self-pay

Insured and self-paying patients are both seen. If you are claiming on private medical insurance, confirm with your insurer beforehand that Miss Nayar is recognised on your policy and ask exactly what your cover includes, as you may be liable for a shortfall. See insurance and self-pay.