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Mohs Surgery

The Mohs Process


Mohs surgery is performed in the following steps:

  • After local anesthesia, the first step is to remove the visible portion of the tumor. This process is called “debulking” the tumor. Any visible tumor is debulked and discarded, preparing the site for the Mohs layer.
  • Then a thin layer of tissue is surgically excised under and around the debulked defect. This Mohs layer is generally only 1-2mm larger than the clinical tumor.
  • Next, the Mohs layer is precisely mapped and processed in a unique manner and examined under the microscope. Our Mohs surgeons examine 100% of the bottom surface and outside edges of the Mohs layer on the microscopic slides.
  • If any tumor is seen during the microscopic examination, its location is marked on the map and a thin layer of additional tissue is excised from the precise area involved. The microscopic examination is then repeated. The entire process is continued until no tumor is found and is completed in one visit.

Reconstruction


After the skin cancer has been completely removed, a decision is made on the best method for treating the wound created by the surgery. These methods include letting the wound heal by itself, closing the wound in a side-to-side fashion with stitches, or closing the wound with a skin flap or graft. The best method is determined on an individual basis. All wound repairs are performed immediately while the site is still anesthetized. All of our Mohs surgeons have undergone extensive specialized reconstructive surgery training for repairing the wound. On a rare occurrence, other surgical specialists may be utilized for their unique skills if warranted.