Mohs Micrographic Surgery Q&A

How does it work?

Mohs surgery is usually done as an outpatient procedure in a doctor’s office or hospital. Local anesthetic is used to numb the area. The surgeon uses a scalpel to remove the part of the tumor that can be seen along with a thin layer of tissue underneath. A temporary bandage is placed on the cut (incision).

Right after removal, the tissue sample is taken to the lab (pathologist) which is usually sitting in the same office of surgeon, to be looked at under a microscope to find out if there are still cancer cells in the tissue. If there is cancer in the layer, another thin layer of tissue is removed and examined. Each round takes about an hour. The surgery takes 20 to 30 minutes and looking at the tissue under the microscope takes about 30 minutes.

What kind of skin cancers are treated by Mohs Surgery?

Mohs Surgery is recommended for skin Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC) once the skin cancer:

• Is aggressive or large

• Appears in an area with little tissue beneath it (e.g., eyelid, nose, ear, scalp, genitals, hand, or foot)

• Was treated and has returned

How Mohs Surgery is different from the classic skin cancer surgery?

The Mohs process examines 100 percent of the tissue margins under the microscope, whereas in standard surgical excision only 1 percent of the margins are examined microscopically. Mohs surgery also conserves the greatest amount of healthy tissue, giving you the smallest scar possible.

Is Mohs Surgery safe?

Mohs surgery is generally considered very safe, but there are some very minor risks such as mild bleeding, light tenderness, itching and scar. 

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Who can do Mohs Surgery?

Mohs surgeon is a skillful dermatologist surgeon who learns about Mohs surgery in an extra training course. Mohs surgeons have undergone specialized training — called a fellowship — to learn more about the procedure and become more proficient in Mohs surgery.