Mohs Micrographic Surgery

The Mohs process includes a specific sequence of surgery and pathological investigation. At this time the surgeon examines the removed tissue for evidence of extended cancer roots. Mohs micrographic surgery is performed under local anesthetic. Once the anesthesia takes effect, the patient will not feel any pain during the procedure.

Mohs surgeons:

• Remove a thin layer of tissue that contains the tumor and a small margin.
• They create a “map” or drawing of the removed tissue to be used as a guide to the precise location of any remaining cancer cells.
• The thin tissue layer is prepared on a slide to read.
• The slide is microscopically examined to check for evidence of remaining cancer cells.

If any of the sections contain cancer cells, Mohs surgeons:

• Return to the specific area of the tumor site as indicated by the map.
• Remove only another thin layer of tissue from the specific area within each section where cancer cells were detected.
• Microscopically examine the newly removed tissue for additional cancer cells.

If the microscopic analysis still shows evidence of disease, the process continues, layer by layer, until the cancer is completely gone.

Post surgical results and management are individualized to achieve the best results and to preserve functional capabilities and maximize aesthetics. Our Mohs surgeons at Core Dermatology are also trained in reconstructive surgery, and will usually perform the reconstructive procedure necessary to repair the wound. In some cases, our board-certified plastic surgeon will assist with the reconstruction procedure so the patient has the best final cosmetic result. A small wound may be allowed to heal on its own, or the wound may be closed in a straight line with stitches. Other surgical defects may be best repaired using a skin graft or a flap of adjacent skin.