Mohs Surgery: What to Expect

Mohs surgery is the gold standard for removing skin cancers, including basal cell and squamous cell carcinoma and some forms of melanoma. When performing a Mohs micrographic procedure, our dermatologists will excise as much of the cancerous tissue as possible while doing minimal damage to surrounding healthy skin.

In contrast to a standard excision – which involves removing the visible cancer and the healthy skin around it in a single unit – Mohs surgery allows us to eliminate all the damaged cells one layer at a time, carefully checking the tissue margins under a microscope for the presence of cancerous cells. This approach improves the chances of an immediate and complete cure while reducing the need for future treatments.

Who Is a Good Candidate for Mohs Surgery?

Often, skin cancers go undetected in their earliest stages because they are usually small and don’t have any noticeable symptoms. That’s why it’s wise to schedule an annual exam with a qualified dermatologist who can spot signs of cancer early.

If you have open cuts or sores that don’t heal, new or changing growths or lesions, or any unusual-looking skin concerns, please contact our office to schedule a skin cancer screening. At that appointment, our board-certified dermatologists will examine you, perform a biopsy if necessary, and let you know if you might benefit from Mohs surgery.

What Happens During Mohs Surgery?

Wear casual, comfortable clothes to your surgical appointment. We suggest dressing in layers, so you can easily adjust if you get hot or cold. You won’t need to change into a surgical gown if the cancerous cells are somewhere accessible, like on your face, neck, back, or hands.

Our expert physicians perform Mohs surgery using a local anesthetic and oral sedation, so you won’t feel any discomfort during your procedure. Once the anesthetic has taken effect, your surgeon will use a scalpel to remove one layer of tissue at a time, checking its margins under a microscope for the presence of cancerous cells and repeating the process until there are no remaining signs of skin cancer.

It’s not possible to predict how long Mohs surgery will take because a superficial exam doesn’t tell the whole story of how extensive your cancer might be. In most cases, the procedure only lasts a few hours, but we may still suggest clearing your schedule for a whole day in case your surgery turns out to be lengthy. However, a fair amount of that time on your part will involve waiting for the surgeon to perform their detailed analysis. We recommend bringing reading material or other entertainment to alleviate potential boredom. You can use the restroom or have a snack, but you will need to remain in our office until your last tissue sample is cancer-free.

What Happens After Mohs Surgery?

After your dermatologist has removed all the affected skin, they will suggest ways to repair the wound. Depending on the extent of your operation, options might include:

  • Suturing the wound closed
  • Letting it heal by itself
  • Using a graft taken from another, inconspicuous area of your body to repair it

If reconstructing the treated area is necessary for cosmetic reasons, we can usually do so immediately after your Mohs surgery.

Providing Leading Dermatology Solutions Since 1903

At Dermatology Medical Group of San Francisco, our experienced physicians are proud to uphold a tradition of excellence that has lasted more than a century. Though cutting-edge treatments like Mohs surgery are far more advanced than what our predecessors could provide, our patient-first philosophy has remained unchanged. To learn more about skin cancer surgery or any of the other medical and cosmetic procedures we offer, please reach out to us today.