What to Expect with Mohs Micrographic Surgery

What to Expect

Mohs surgery is an outpatient procedure that requires only local anesthesia. That means treatment and recovery are quick, painless and easy. Here is what you can expect:

Step 1: We remove the section of tumor that is visible without a microscope.

Step 2: Next, we remove a layer of surrounding skin tissue and mark it for reference, along with the surgical site.

Step 3: We examine the tissue sample under a microscope and identify sections with cancer cells.

Step 4: Steps 2 and 3 are repeated if necessary, but just for sections with cancer cells. While the exact approach depends on the tumor, it typically takes 1 to 3 rounds to make sure all the cancer is removed.

Step 5: Your surgeon discusses the best way to repair the surgical site — natural healing for small or shallow wounds, sometimes stitches and occasionally a flap from adjacent skin or a skin graft from other areas of the body. On rare occasions, your doctor will bring in another reconstruction specialist from Stanford.

Step 6: We schedule future checkups to monitor your recovery and watch for any signs the cancer has returned. Your surgeon remains available for all questions and concerns.

Surgical excision and skin cancer

Occasionally, a more traditional treatment option called surgical excision is more appropriate for our skin cancer patients. We perform this procedure to remove benign cysts and abnormal moles as well. As with Mohs surgery, our doctors take the time to fully explain their treatment recommendations.

Surgical excision usually takes about 30 minutes for smaller tumors. While the treatment does involve the removal of a small amount of healthy tissue surrounding the growth, it still offers high cure rates. Our skilled surgeons also work to minimize scarring.

During surgical excision, you will receive local anesthesia so you will not feel any pain during the procedure. Your surgeon will:

• Outline the tumor and a "safety margin" of healthy skin to capture all cancer cells
• Surgically remove the marked area
• Send the "safety margin" sample for lab analysis