Mohs Micrographic Surgery
by Deanna M. Neff, MPH
This procedure is used to remove skin cancer that affects the face and other sensitive areas. The doctor removes the cancer layer by layer, examining the tissue under a microscope until only healthy tissue remains.
Reasons for Procedure TOP
This surgery is an effective and precise way to treat basal and squamous cell skin cancers. It offers a good chance for complete removal of the cancer, while sparing normal tissue.
Possible Complications TOP
Complications are rare, but no procedure is completely free of risk. If you are planning to have Mohs surgery, your doctor will review a list of possible complications, which may include:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
What to Expect TOP
Prior to Procedure
In the time leading up to the procedure:
Local anesthesia will be used. You will not feel pain. You will be awake during the procedure.
Description of Procedure TOP
The area will be cleansed with antiseptic. A local anesthetic will be injected into the area. Using a small scalpel, the doctor will remove the top visible portion of the cancer. Next, the doctor will remove another, deeper layer. The layer will be divided into sections. Each section will be color coded. This will allow the doctor to know exactly where the layer was in the skin.
These sections will be frozen and examined under a microscope for remaining cancer cells. If cancer is found at the edges of the removed layer, the doctor will go back to the precise section. Additional layers will be removed until all areas are cancer free. For larger wound areas, the doctor will close the wound with stitches, skin flap, or a skin graft procedure. Small, shallow wounds may heal without stitches.
How Long Will It Take? TOP
The surgery will go quickly. You will have to wait while the doctor examines the tissue microscopically. In some cases, this procedure can last for several hours.
How Much Will It Hurt? TOP
You should have minimal discomfort during the procedure. There will be some minor pain during recovery. You may be given pain medicine.
Post-procedure Care TOP
At the Care Center
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
After the procedure, you may be given pain medicine and an antibiotic. You will be able to leave the same day.
When you return home, do the following to help ensure a smooth recovery:
Call Your Doctor TOP
After arriving home, contact your doctor if any of the following occurs:
If you think you have an emergency, call for medical help right away.
American College of Mohs Surgery
American Society for Mohs Surgery
Canadian Association of Mohs Surgeons
Canadian Cancer Society
Narayanan K, Hadid OH, Barnes EA. Mohs micrographic surgery versus surgical excision for periocular basal cell carcinoma. The Cochrane Collaboration website. Available at:
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Published April 15, 2009. Accessed February 2, 2010.
6/6/2011 DynaMed's Systematic Literature Surveillance
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: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis.Am J Med. 2011;124(2):144-154.e8.
Last reviewed June 2013 by Marcin Chwistek, MD
Last Updated: 1/24/2014