Mohs Surgery
Mohs surgery, also called Mohs or Mohs micrographic surgery, is a specialized treatment for removing skin cancer. Your dermatologist will determine if Mohs surgery is appropriate for treating your skin cancer, depending on the type of skin cancer you have and its location.
What is Mohs Surgery?
Mohs surgery is the surgical removal of skin cancer from your skin, layer by layer. Mohs surgery is the only treatment method that allows the evaluation of skin cancer cells during the procedure, which results in the highest cure rate possible while removing the least amount of normal tissue.
Used to treat skin cancer, this surgery has a unique benefit. During surgery, the surgeon can see where the cancer stops. This isn’t possible with other types of treatment for skin cancer.
The ability to see where the cancer stops gives Mohs (pronounced Moes) two important advantages:
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- Mohs has a high cure rate.
- Mohs allows you to keep as much healthy skin as possible because the surgeon only removes the skin with cancer cells. This is especially important when skin cancer develops in an area with little tissue beneath (e.g., eyelid, ear, or hand).
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How is Mohs Surgery performed?
Mohs surgery is usually performed as an outpatient procedure in a dermatologist’s office or outpatient surgical suite. You remain awake during Mohs, and are given a local anesthetic to numb the surgical area. The use of a local anesthetic instead of general anesthesia, which puts the patient to sleep, reduces recovery time and has fewer side effects.
If you are concerned about discomfort during the procedure, ask your Mohs surgeon if a mild sedative or additional pain reliever can be provided to make you feel more comfortable.
Once the anesthesia has taken effect, the Mohs surgeon removes the visible skin cancer. The tissue that is removed is examined under a microscope by the Mohs surgeon to determine if there are any cancer cells remaining at the outer edges of the removed tissue. During this time, you remain in the surgical suite or office.
If cancer cells are still present at any edge of the removed tissue, the Mohs surgeon will continue to cut out additional layers of skin or underlying affected tissue until the cancer cells are no longer seen. This technique allows for the complete removal of the skin cancer, yet minimizes the removal of healthy skin. In most cases, Mohs surgery can be completed within a day or less.
The Mohs Surgery Process
If you have Mohs surgery, you’ll see a doctor who is a trained Mohs surgeon. Most Mohs surgeons are dermatologists who have completed extensive training in Mohs surgery.
During Mohs surgery, most patients remain awake and alert. This means Mohs can safely be performed in a medical office or surgical suite. Only if extensive surgery is necessary would you be admitted to a hospital.
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- On the day of the surgery, your surgeon will first examine the area to be treated. You’ll then be prepped for surgery. This includes giving you an injection of anesthetic. This injection only numbs the area that will be operated on, so you’ll be awake during the surgery.
- Once the anesthetic takes effect, the surgery can begin. The surgeon starts by first cutting out the visible skin cancer. Next, the surgeon removes a thin layer of surrounding skin. You’re then bandaged so that you can wait comfortably.
- While you wait, the Mohs surgeon looks at the removed skin under a microscope. The surgeon is looking for cancer cells. If cancer cells are found, you’ll need another layer of skin removed.
- This process of removing a thin layer of skin and looking at it under a microscope continues until the surgeon no longer sees cancer cells.
- Once cancer cells are no longer seen, your surgeon will decide whether to treat your wound. Some wounds heal nicely without stitches. Others need stitches. To minimize the scar and help the area heal, some patients require a skin graft or other type of surgery.
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If you need wound treatment, your Mohs surgeon may treat the wound that same day. Some patients with a large wound are referred to another surgeon for wound treatment.