Overview of Mohs Surgery
What is Mohs Surgery?
Mohs surgery is a specialized, highly effective procedure for treating skin cancer, particularly basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). It is a precise, tissue-sparing technique that removes cancer layer by layer while preserving as much healthy skin as possible.
What Does Mohs Surgery Stand For?
Mohs surgery is named after Dr. Frederic Mohs, who pioneered the technique. It is also called Mohs micrographic surgery, emphasizing its microscopic tissue examination during the procedure.
What is a Mohs Procedure?
Mohs surgery involves removing cancerous tissue in stages, examining each layer under a microscope to ensure all cancer is removed before closing the wound. This approach minimizes scarring and maximizes cure rates.
Indications for Mohs Surgery
What Qualifies for Mohs Surgery?
Mohs surgery is recommended for skin cancers that are:
- Located in high-risk areas (face, ears, nose, lips, hands, feet, or genitals)
- Recurrent or aggressive
- Large or deep tumors
- Poorly defined margins
- Certain cases of melanoma in situ
What Type of Cancer is Mohs Surgery For?
Mohs surgery is used to treat:
- Basal cell carcinoma (BCC)
- Squamous cell carcinoma (SCC)
- Some early-stage melanomas (melanoma in situ)
Is Mohs Surgery Necessary for Basal Cell Carcinoma?
Not all BCCs require Mohs surgery, but it is the best option for aggressive, recurrent, or high-risk cases.
Procedure Details
How Long Does Mohs Surgery Take?
The procedure typically lasts 2 to 4 hours, though it may take longer depending on how many layers need to be removed.
Is Mohs Surgery Serious?
While Mohs surgery is a surgical procedure, it is performed under local anesthesia in an outpatient setting, making it safe and minimally invasive.
Is Mohs Surgery Painful?
The procedure itself is not painful due to local anesthesia. After surgery, mild soreness is expected, but it is manageable with over-the-counter pain relievers.
Risks and Benefits
What are the Benefits of Mohs Surgery?
- Highest cure rate (up to 99%) for certain skin cancers
- Minimally invasive, preserving healthy skin
- Immediate microscopic examination ensures complete removal
- Reduces the risk of cancer recurrence
- Optimal cosmetic outcomes with minimal scarring
What are the Risks of Mohs Surgery?
- Bleeding or bruising
- Infection (rare but possible)
- Scarring (minimized compared to other surgeries)
- Temporary numbness or nerve injury (rare but possible)
- Skin tightness during healing
Recovery and Healing
How Long Does Swelling Last After Mohs Surgery on the Face?
Swelling peaks within the first 48 hours and usually resolves within one to two weeks.
What is the Recovery Process Like?
Immediately After Surgery:
- The area is bandaged, and you may have stitches.
- Swelling and mild discomfort are normal.
- Avoid strenuous activity for at least one week.
First Week of Recovery:
- Swelling and bruising improve.
- Stitches are removed within 5 to 14 days.
- Wound care is essential to prevent infection.
Long-Term Healing:
- The scar fades over several months.
- Sun protection and scar treatment can improve cosmetic results.
Long-Term Outlook
What is the Long-Term Outlook After Mohs Surgery?
Mohs surgery offers the best chance of complete cancer removal, with low recurrence rates and excellent cosmetic outcomes. However, patients with a history of skin cancer should:
- Schedule regular skin checks
- Use sun protection to prevent future skin cancers
- Monitor for new skin changes
Insurance and Costs
Does Medicare Cover Mohs Surgery?
Yes, Medicare typically covers Mohs surgery when it is medically necessary for skin cancer treatment. Our office can assist in verifying your insurance benefits.
When to Call the Doctor
- Excessive Bleeding – If bleeding continues despite applying firm pressure for 10-15 minutes.
- Signs of Infection – Increasing redness, swelling, warmth, pus, or fever.
- Severe Pain That Doesn’t Improve – Mild discomfort is normal, but worsening pain is a concern.
- Wound Opening – If stitches break or the wound reopens, call your doctor.
- Numbness or Weakness – If persistent or worsening, it should be evaluated.
Final Thoughts
Mohs surgery is the most effective treatment for certain skin cancers, offering high cure rates, minimal scarring, and same-day results. If you have been diagnosed with basal cell carcinoma, squamous cell carcinoma, or another high-risk skin cancer, consult with a fellowship-trained Mohs surgeon to discuss your options.