If you have been diagnosed with skin cancer, knowing what to expect during Mohs surgery can help you feel more prepared and less anxious. Mohs micrographic surgery is a specialized procedure used to remove certain skin cancers while preserving as much healthy tissue as possible.
During Mohs surgery, a surgeon removes the visible tumor along with a thin layer of surrounding tissue. That tissue is examined under a microscope right away. If cancer cells remain, another thin layer is removed and examined. This process continues until no cancer cells are found in the tissue margins.
What to Expect During Mohs Surgery
Mohs surgery is usually performed as an outpatient procedure using local anesthesia, which numbs the treatment area while you remain awake.
Before the Procedure
Your Mohs surgeon will examine the skin cancer and review your medical history. You may be asked about:
- Medications and supplements you take
- Allergies
- Previous surgeries
- Medical conditions
- Bleeding or clotting problems
Follow your surgeon’s instructions about medications before surgery. Do not stop prescription blood thinners or other medications unless your healthcare provider specifically tells you to do so.
On the day of surgery, wear comfortable clothing and plan for the possibility that you may be at the office for several hours.
Step-by-Step: How Mohs Surgery Works
1. The Area Is Numbed
The surgeon cleans the skin and injects a local anesthetic around the skin cancer. You should not feel sharp pain during the procedure, although you may notice pressure or movement.
2. The Visible Cancer Is Removed
The surgeon carefully removes the visible portion of the tumor, along with a thin layer of tissue around it.
The removed tissue is prepared for microscopic examination. Unlike standard excision, Mohs surgery allows the surgeon to examine the tissue margins during the procedure.
3. The Tissue Is Examined
The tissue is processed and examined under a microscope to determine whether cancer cells remain at the edges.
If cancer is still present, the surgeon identifies where those cells are located and removes another thin layer from that specific area.
4. The Process Is Repeated
Additional layers are removed and examined until the margins are clear of cancer cells.
This tissue-sparing approach can be particularly valuable when skin cancer develops in areas where preserving healthy tissue and appearance is important, such as the nose, eyelids, ears, lips, and other areas of the face.
How Long Does Mohs Surgery Take?
The actual removal of each tissue layer may be relatively quick, but microscopic processing takes time. Because several rounds may be necessary, the overall appointment can take several hours.
There is no reliable way to predict exactly how long your procedure will take. The number of stages depends on the size, location, and characteristics of the skin cancer.
Bring something to read, listen to, or do quietly while waiting for your tissue to be examined.
What Happens After Mohs Surgery?
Once your surgeon confirms that the cancer has been completely removed, the surgical wound will be treated.
Depending on the size and location of the wound, options may include:
- Healing naturally through a process called secondary intention
- Closing the wound with stitches
- A skin flap, which moves nearby skin over the wound
- A skin graft, which uses skin from another area
Your surgeon will recommend the approach that best fits your wound and individual needs.
Recovery and Wound Care
Your surgical site may be tender, swollen, or bruised after Mohs surgery. Mild discomfort is common and can often be managed according to your surgeon’s instructions.
Carefully follow your wound-care instructions. These may include keeping the area clean, applying prescribed ointment, changing dressings, and avoiding activities that could cause bleeding or strain the wound.
Contact your medical team if you develop increasing pain, significant bleeding, spreading redness, worsening swelling, drainage, or fever.
Is Mohs Surgery Painful?
Most patients experience little or no pain during the procedure because the treatment area is numbed with local anesthesia. You may feel pressure or pulling during surgery.
Some soreness can occur after the anesthetic wears off. Your surgeon will provide instructions for managing discomfort and caring for the surgical site.
Why Is Mohs Surgery Used for Skin Cancer?
Mohs surgery is commonly used for selected basal cell carcinomas and squamous cell carcinomas, especially cancers that are located in cosmetically or functionally important areas, have aggressive features, have returned after previous treatment, or have borders that are difficult to define.
For some melanoma cases, specialized Mohs techniques may also be considered. Treatment decisions depend on the specific type, stage, location, and characteristics of the cancer.
Your dermatologist or Mohs surgeon can explain why Mohs surgery may or may not be appropriate for your diagnosis.
Preparing for Your Mohs Surgery
A little preparation can make your appointment easier.
Before surgery:
- Follow your surgeon’s medication instructions.
- Eat and drink normally unless you are given different instructions.
- Wear comfortable clothing.
- Avoid applying makeup or skincare products directly over the treatment area.
- Arrange transportation if your medical team recommends it.
- Plan to keep your schedule flexible in case multiple Mohs stages are needed.
Most importantly, ask questions if you are unsure about anything before your procedure. Understanding the treatment plan can make the experience less stressful.
3 Key Takeaways
- Mohs surgery removes skin cancer layer by layer while examining tissue under a microscope during the procedure.
- The appointment may take several hours, because each tissue layer must be processed and examined before the surgeon knows whether additional tissue needs to be removed.
- Following your surgeon’s wound-care instructions is essential for proper healing and reducing the risk of complications.
If you have been diagnosed with skin cancer and want to learn more about your treatment options, Unified Health can help you understand the next steps.
Schedule a consultation with Unified Health:
www.unifiedhealthusa.com/online-booking
Medical Disclaimer: This article is for informational purposes only and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional regarding your individual medical condition and treatment options.
