Surgical Dermatology Services

How is Mohs surgery performed?

Before the procedure, the treatment area will be thoroughly cleansed, and a drape may be used to isolate it from the surrounding tissue. A local anesthetic will be injected around the treatment area to numb it thoroughly. No general anesthesia is required. Once the lesion is removed, it’s immediately evaluated under a microscope to determine if the edges or margins of the excised tissue are clear of cancer cells. If the margins are free of cancerous tissue, that’s an indication that all cancer cells have been removed, and the surgical site can be closed with sutures. When cancer cells are present on one or more margins, additional tissue will be removed in those areas, and that tissue will be re-evaluated. The process of excision, followed by microscopic evaluation, continues until all margins are clear. At this point, the incision site will be closed using tiny sutures, and a dressing will be applied. Mohs surgery can be performed as an outpatient procedure, and patients will be discharged soon after completing their process.

Advantages of the Mohs Surgical Procedure:

Some skin cancers can be deceptively large - far more extensive under the skin than they appear to be from the surface. These cancers may have “roots” in the skin or along blood vessels, nerves, or cartilage. Skin cancers that have recurred following previous treatment may send out extensions deep under the scar tissue that has formed at the site. Mohs surgery is specifically designed to remove these cancers by tracking and removing these cancerous “roots.” For this reason, it is impossible to predict precisely how much skin will have to be removed before Mohs surgery. However, the Mohs surgery removes only the cancerous tissue, while the normal tissue is spared.