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What is Mohs Surgery?

Mohs surgery was developed in 1938 by a general surgeon, Frederic E. Mohs. It is a precise surgical technique used to treat common types of skin cancer. The goal of Mohs surgery is to remove as much of the skin cancer as possible, while minimizing damage to surrounding healthy tissue.

What are the Benefits?

The main benefits of Mohs surgery are it’s precision and that it is usually done in an outpatient setting. Mohs surgery allows surgeons to verify that all cancer cells have been removed at the time of surgery, thereby increasing the chance of a cure and reducing the need for additional treatments or additional surgery. Mohs surgery is an advancement over standard surgery (local excision), which is less precise and involves removing the visible cancer and a small margin of surrounding healthy tissue all at once.

Mohs surgery is especially useful for skin cancers that:

  • Have a high risk of recurrence or that have recurred after previous treatment.
  • Are located in areas where you want to preserve as much healthy tissue as possible, such as around the eyes, ears, nose, mouth, hands, feet and genitals.
  • Have borders that are hard to define.
  • Are large or aggressive.

Procedure Details

Mohs surgery is done on an outpatient basis in an operating room or procedure room that has a laboratory nearby. Although in most cases the procedure lasts a few hours, the actual time of the procedure varies, and doctors therefore often advise reserving the whole day for the procedure.

During the procedure, your surgeon uses a scalpel to remove the visible portion of the cancer along with a thin, underlying layer of tissue that’s slightly larger than the visible tumor. A temporary bandage is placed on your incision. This takes only a few minutes. The surgeon then takes this tissue to the laboratory for analysis, which is the portion of the procedure that typically takes the most time.

What are the Risks?

As with any surgical procedure, Mohs surgery carries the risk of:

  • Bleeding
  • Pain or tenderness around the surgical site
  • Infection

Other complications that may result from Mohs surgery are uncommon but may include:

  • Temporary or permanent numbness surrounding the surgical area, if small nerve endings are cut
  • Temporary or permanent weakness of the surgical area, if the tumor is large and a muscle nerve is severed
  • Itching or shooting pain in the affected area
  • An enlarged scar (keloid)

Results & Follow-up

After all of the cancer has been removed, you and your surgeon can decide on how to repair the wound. Depending on the extent of the operation, this might include:

  • Letting the wound heal on its own (healing by second intention)
  • Using stitches to close the wound (primary closure)
  • Shifting skin from an adjacent area (skin flap) to cover the wound
  • Using a skin graft from another part of the body, such as behind the ear, to cover the wound

One of the advantages of Mohs surgery is that you know your results right away, and you usually don’t leave your appointment until all of the skin cancer has been removed. You may have a follow-up visit with your surgeon or referring doctor to monitor your recovery to make sure your wound is healing properly.