Mohs Micrographic Surgery

Mohs surgery is a precise surgical technique used to treat skin cancer. During Mohs surgery, thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains.

Mohs surgery has come to be accepted as the single most effective technique for removing Basal Cell Carcinoma and Squamous Cell Carcinoma (BCCs and SCCs), the two most common skin cancers. It spares the greatest amount of healthy tissue while also most completely expunging cancer cells; cure rates for BCC and SCC are significantly better than the rates for standard excision or any other accepted method which can result in the unnecessary removal of healthy skin tissue and tumor regrowth if any cancer is missed.

In Mohs surgery, each layer is examined under a microscope until healthy, cancer-free tissue around the tumor (called a clear margin) is achieved. Mohs surgeons are trained as a cancer surgeon, pathologist, and reconstructive surgeon. Mohs surgery has the highest success rate of all treatments for skin cancer–up to 99 percent.

Advantages of Mohs surgery include:

  • Ensuring complete cancer removal during surgery, dramatically decreasing the chance of cancer growing back.
  • Minimizing the amount of healthy tissue lost
  • Maximizing the functional and cosmetic outcome
  • Providing a highly effective approach to cancer treatment

Before Surgery

There are a few things you can do to prepare for Mohs surgery. Stop taking ibuprofen (such as Advil or Motrin) or other oral non-steroidal anti-inflammatory drugs (NSAIDs) seven days before surgery. You should check with your doctor about any other blood-thinning medications and should avoid taking any herbal medications (such as St. John’s wort, ginkgo biloba, vitamin E, garlic, ginseng, fish oil) that predispose you to bleeding and bruising. Do not drink alcohol for 48 hours prior to surgery.

On the morning of surgery, you can eat a normal breakfast and take your regular medications. The procedure can take many hours depending on the extent of the tumor and the amount of reconstruction necessary, for this reason you may want to bring something to read or pass your time as there will be a wait between stages of Mohs surgery.

After the Procedure

You should have little or no pain after the procedure. Acetaminophen (Tylenol®) or, in rare instances, a stronger painkiller, should take care of any discomfort. Major complications are rare with Mohs surgery. You may experience some minor swelling and bruising, but that will fade in a few days. Some people have an allergic reaction to the adhesive tape, but that too goes away quickly. If you have any minor bleeding, just apply firm pressure to the area. Infections are rare, but easily treated with antibiotics.

Healing time varies, depending on your age, medical history, and type of operation. Sutured wounds usually heal in two to three weeks. Skin grafts or flaps can take a few months. For wounds that heal by secondary-intention, the healing time is usually one to three months. Aftercare instructions are available on the wound care section of our website.

Follow-up appointments are scheduled depending on the type of sutures or repair that was done. Because you have had skin cancer, you should see your dermatologist every 6 months for a skin exam or early if you notice any new or concerning spots on your skin.

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