Call Us Today:

Mohs Micrographic Surgery

Home > Treatment > Surgical Treatment> Mohs Micrographic Surgery



Mohs micrographic surgery is a highly specialized surgical technique for skin cancer removal. Developed by Dr. Frederick Mohs in the late 1930s, the technique is now practiced throughout the world. Mohs surgery allows for the immediate microscopic examination of the removed cancerous tissue. This eliminates days of waiting for a pathology report from an outside lab. The cancer is shaved off one level (layer) at a time and is immediately examined under the microscope. If cancer extension is seen at the margins, then additional tissue layers are shaved off. This process is repeated until all the margins are clear. This method has the highest cure rate while preserving healthy tissue and maximizing cosmetic results.


Often performed as an outpatient procedure in a physician’s office, this procedure is performed by a dermatologist with specialty training in Mohs surgery. The first step is injecting the area to be treated with a local anesthetic using a tiny needle. The Mohs surgeon then removes the visible cancer along with a thin layer of additional tissue. This is known as a level. It is not possible to predict the extent of the skin cancer, however, many cases have been completed in 1-3 levels of tissue. The patient waits with a temporary bandage while the tissue is processed by the Mohs technician and then examined by the Mohs surgeon. The technician processes the tissue by cutting, staining and mapping. Then, the specimen is frozen, thinly sliced, and placed on slides for examination under a microscope. The Mohs surgeon examines the slides of the specimen carefully to be sure all margins (edges) are clear of cancer cells. If remaining areas of the cancer are identified, additional tissue will then be removed. When all residual cancer is removed, the remaining defect (open wound) can then be reconstructed (closed).


Surgical repair (reconstruction) depends on the size, depth, and location of the defect. In some cases, the defect is in a discreet area or is small in size and can be closed by the Mohs surgeon. Sometimes the location of the defect is on a visible area of the body such as the face which may require a plastic surgeon who is able to use more advanced techniques to ensure a cosmetically appealing outcome.


For patient convenience Mohs micrographic surgery and reconstruction can be performed on the same day at the same facility. It is possible, however, to wait up to one week between Mohs surgery and reconstruction due to patient medical reasons. Reconstruction can be done under local anesthetic as an office procedure or under IV sedation in an outpatient surgical center. The unique set-up of the Skin Cancer and Reconstructive Surgery Center allow same-day and same-place reconstruction and Mohs surgery.

Related Articles

Cerclage Closure Technique
HISTORY A 50 y/o patient presents with a 3 year h/o right cheek growing lesion biopsied by outside office on 11/8/21 showing atypical lentiginous melanocytic proliferation. Incisional biopsy of right malar cheek done on 11/18/21 showing severely atypical lentiginous junctional melanocytic hyperplasia with margins involved. Excision and reconstruction with cerclage of right malar cheek severe…
Read More
Sensory Symptoms with Skin Cancers
HISTORY A 68-year-old woman presented with left cheek radiating, shooting pains in the area of biopsy proven  basal cell carcinoma. The neuralgia symptoms radiated to the nose, eye, and temple. MRI of the face was non-contributory. Mohs excision was performed by the dermatologist. Additional margin wide local excision was performed at the reconstructive procedure. Patient…
Read More
Recurrent BCC of the External Ear After Radiation
HISTORY A 77-year-old man presents with 5-year history of infiltrative basal cell carcinoma (BCC) of the left ear fossa triangularis and root of helix. The area was originally treated with four weeks of radiation in 2014, complicated by temporary ulceration and healing with adhesion. When the area developed crusting a couple of years later, the…
Read More
Recurrent SCC of Nasal Tip
HISTORY 71-year-old man presents with recurrence of SCC of nose following Mohs excision on 2-9-17. Partial rhinectomy was performed with incomplete Mohs excision leaving residual positive margins due to patient’s comfort.  Two additional excisions of involved margins were done under anesthesia achieving clear margins. First stage reconstruction was performed on 4-11-18. DISCUSSION Management of a…
Read More
Upper Chest BCC PNI
HISTORY 53-year-old man presents with a 4-year-history of BCC of upper chest.  The tumor measured 12 cm x 6 cm. Wide local excision with 1 cm margins on 11/10/2017 found clear margins and perineural invasion. The nerves up to 0.23 mm were involved by tumor. The final defect was 13.5 cm x 8.3 cm.  …
Read More
Lower Leg Wound Treatment At Scars Center
Lower Leg Wound Dehiscence
HISTORY 74-year-old man presents with BCC of left lower leg treated with Mohs excision and closure on 2-27-18. Patient presented 5 days post closure with wound dehiscence. Cutimed wound sponge dressing was used for wound management.  Debridement was performed 3-16-18. Plan is for closure with matrix xenograft.       DISCUSSION Lower leg wound dehiscence…
Read More


Receive research updates, inspiring stories, healthy living tips and more.

Something went wrong. Please check your entries and try again.



© 2018 SCARS Management Services. All rights reserved.