Your Mohs Procedure
Mohs skin cancer surgery is an outpatient procedure, which takes place in our on-site surgical suite. Our suite is equipped with a dedicated Mohs laboratory for microscopic examination of tissue. Surgeries start early in the morning and are completed the same day, depending on the extent of the tumor and the amount of reconstruction necessary.
First, you will 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, possible side effects from general anesthesia, and cost. You are completely numb in the area of the surgery, however, so the procedure is comfortable.
After the area has been numbed, all visible tumor, along with a thin layer of surrounding tissue, is excised. Patients are bandaged and returned to rest in the reception area to await testing results. A specially trained technician prepares the tissue and puts it on slides for your surgeon to examine under a microscope. If cancer involving the outer edges of the removed tissue is seen by the surgeon, then another layer of tissue is excised from the area where the cancer was detected. This ensures that only cancerous tissue is targeted during the procedure, minimizing the loss of healthy tissue. These steps are repeated until all samples are free of cancer. Most tumors require 1 to 3 stages for complete removal. Aggressive cancers can take several stages of surgery to cure.
After Your Surgery
When your surgery is complete, your Mohs surgeon assesses the wound and discusses your options for optimal functional and cosmetic outcome. Because Mohs surgery spares the maximal amount of healthy tissue, management of the wound can often be simplified and lower risk. Choices could include natural healing without stitches, simple side-to-side stitched closures, or skin flaps and grafts. Every wound is specially managed to maximize aesthetic, functional outcome in accordance with individual patient preference. If reconstruction is necessary, repairs are usually performed the same day as the tumor removal. Wounds requiring a skin graft may be repaired later to maximize graft outcome.