Mohs surgery is an outpatient procedure that can be performed in your doctor’s office. You are awake for the entire procedure. The area to be treated on your skin is first numbed with a local anesthetic and cleansed.
Your surgeon will remove the visible skin cancer and only a thin layer of healthy tissue. Your doctor will cut the specimen into four sections and map it. A technician freezes the tissue and removes very thin slices for examination. This is the most time consuming part of the entire procedure. It often requires at least one hour of preparation time.
Your surgeon will carefully examine the specimen. All remaining cancer and microscopic roots are pinpointed on the map. Your surgeon will use the map to remove additional tissue only where cancer is present. This process is methodically repeated until no cancer remains.
Most Mohs surgeries can be completed in three stages or less. The treatment process may require up to four hours to complete. You should plan on spending a large block of time or a whole day for your procedure because it is impossible to predict the extent of the skin cancer’s roots before surgery.
When the Mohs microsurgical process is complete, the wound is closed. Wound closure depends on the location and size of the affected area. Small wounds may simply be closed with stitches. If there is little tissue left to cover and close the wound, a skin flap may be used. A skin flap involves surgically rotating or moving nearby skin to secure it over the wound. In some cases, a skin graft may be necessary. A skin graft entails removing a section of skin from another area on the body and securing it over the wound.
Mohs microsurgery leaves the smallest scar possible. Complications from scars may be treated with several procedures, including injected medications and laser resurfacing. Skin grafts and flaps may also be “touched up” to improve their appearance.