Mohs FAQ

Mohs Surgery is a specialized technique for removing certain types of skin cancers. Dr. Frederic Mohs began performing the procedure in the 1930’s. The procedure has been continuously refined over the past 70 years and it is now an outpatient procedure performed under local anesthesia.

After the tumor and surrounding skin have been completely numbed, the visible portion of the tumor is surgically removed. The tissue is then taken to our laboratory and processed where the physician uses a microscope to see if any cancer cells remain. If no cancer cells are seen, the surgeon will repair the wound with stitches (or allow the wound to heal if stitches are not needed.) If any cancer cells have been left behind, the surgeon will go back and remove additional tissue. This process is repeated as many times as necessary to ensure complete removal of the tumor.

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The term “Mohs” refers to Dr. Frederic Mohs, Professor of Surgery at the University of Wisconsin, who developed this surgical technique in the 1930s. The technique has undergone many refinements and has come to be known as “Mohs micrographic surgery” or simply “Mohs surgery” in honor of Dr. Mohs.

The most common skin cancers are basal cell and squamous cell carcinomas. There are well over 1 million new skin cancers in this country each year. Fortunately, these two cancers do not usually spread to other areas of the body and are rarely life-threatening. However, they can be locally aggressive, meaning they can invade and infiltrate large areas of normal tissue.

There are two primary advantages. First, by using the microscope to examine the tissue, the surgeon is better able to ensure that all cancer cells have been removed. In fact, this procedure has the highest cure rate of all skin cancer treatments. Second, because only cancerous tissue is removed, normal, healthy skin is preserved keeping the defect or “hole” as small as possible. This facilitates a more elegant reconstruction.

The length of the surgery depends on the extent of the skin cancer, but usually takes between 2 to 4 hours. Occasionally, surgery is more lengthy, so we ask that you come prepared to spend the day. Much of the time will be spent waiting for the tissue to be processed in the lab. Bring reading material and whatever else will help keep you comfortable while you are with us.

Many, but not all wounds, require stitches for optimal healing. Our goal is to give you the best cosmetic and functional result possible. Some wounds require more complicated procedures such as “flaps” or “grafts” while others do best if left to heal on their own. Your doctor will recommend the best option following removal of the tumor.

Unfortunately, there is no such thing as “scarless” surgery. However, we are trained in facial reconstruction and our goal is to make your scar as undetectable as possible. The size of the scar often depends on the size of the tumor.

No. The surgery is well-tolerated with local anesthesia. Because the surgery may take several hours, the risk of prolonged general anesthesia is avoided.

Yes. Surgery anywhere on the face can often lead to temporary swelling around the eyes making it difficult to see. Additionally, a 24 hour pressure dressing will be placed over the surgical site which can sometimes make it difficult for glasses to rest properly. Out of concern for your safety, we ask that you bring a driver with you or make arrangements for someone to pick you up.

Yes. Take all your regular medications as they have been prescribed by your doctor unless we specifically tell you otherwise prior to surgery.

Yes. Unless specifically told otherwise, you may eat a normal meal prior to surgery.  It is also a good idea to bring snacks as you may be in the office for several hours.

Continue taking all your prescribed medications unless otherwise directed by us in advance. In general, we do not recommend that you stop taking any blood thinners such as aspirin, Coumadin or Plavix. If there are special circumstances where these need to be stopped, we will notify you.

Yes. Physical activity, including sports and exercise, are often restricted following the surgery. If your job requires heavy lifting or physical exertion, you may need to plan to be off for a few days. Your doctor will give you specific instructions at the time of surgery.

Most people have surprisingly little pain after the surgery. Typically, the first 24 hours are the most uncomfortable. We recommend that you have extra strength Tylenol available, but do not recommend taking Advil, Motrin or Aleve.