The Mohs Surgery Procedure

It's helpful to know what to expect before you undergo any surgical procedure. Because the Mohs surgery procedure for skin cancer removal is somewhat complex, it can be reassuring to become familiar with the treatment process ahead of time. Here, you can learn what to expect before, during, and after your procedure.

Mohs surgery is the most effective treatment for most types of skin cancer. To learn more about your options, find a fellowship trained Mohs surgeon in your area.

Before Your Surgery

When you meet with a surgeon certified by the American College of Mohs Surgery (ACMS) for a consultation, you determine together whether a Mohs surgical procedure is the best course of action for your cancer. Once you have set an appointment for surgery, you receive a detailed list of instructions to follow beforehand. You may be asked to:

Temporarily stop the use of certain medications, including some over-the-counter pain relievers, supplements, and other medicines
Stop consuming certain foods or beverages a number of hours before your procedure
Stop smoking
Clear a full day for your procedure, because it is difficult to predict how long it may take

Your ACMS surgeon and his or her team will give you more information about these and other considerations before your surgery, and it's important to follow this advice as closely as you can to ensure a successful outcome.

Your Mohs Procedure

Surgeons usually perform Mohs skin cancer surgery as an outpatient procedure in the office, which has an on-site surgical suite and a laboratory for microscopic examination of tissue. Typically, surgery starts early in the morning and is completed the same day, depending on the extent of the tumor and the amount of reconstruction necessary.

You receive local anesthesia around the area of the tumor, so you are awake during the entire procedure. The use of local anesthesia versus general anesthesia provides numerous benefits, including preventing a lengthy recovery and possible side effects from general anesthesia. You are completely numb in the area of the surgery, though, so the procedure is comfortable.

After the area has been numbed, your ACMS surgeon removes the visible tumor, along with a thin layer of surrounding tissue. A technician then prepares this tissue and puts it on slides for your surgeon to examine under a microscope. If the surgeon sees evidence of cancer around the outer edges of the removed tissue, he or she takes another layer of tissue from the area where the cancer was detected. This ensures that only cancerous tissue is removed during the procedure, minimizing the loss of healthy tissue. Your surgeon repeats these steps until all samples are free of cancer. Although there are always exceptions to the rule, most tumors require 1 to 3 stages for complete removal.

To get a better picture of how this process takes place, please view our guide, The Mohs Step-by-Step Process.

After Your Surgery

When your surgery is complete, your Mohs surgeon assesses the wound and discusses your options for ideal functional and cosmetic reconstruction. ACMS surgeons understand that a good cosmetic result is an important part of the recovery process, and that's why they work so hard to leave as little tissue damage as possible. If reconstruction is necessary, the Mohs surgeon usually repairs the area the same day as the tumor removal.

Learn more about Mohs surgery recovery, your reconstruction options, and post-operative care.