Surgery Overview

Mohs micrographic surgery involves removing a
skin cancer one layer at a time and examining these layers under a microscope
immediately after they are removed. This procedure allows for a close
examination of each layer of skin to detect cancer cells. It also allows a
minimal amount of tissue to be removed while making sure that all
the cancer cells are removed.

A
local anesthetic is injected into the skin before the
surgery. Your doctor then begins to remove the skin cancer and a small amount
of healthy tissue, one layer of skin at a time. Each tissue layer is prepared
and examined under the microscope for cancer cells. Surgery is complete when no
more cancer cells are detected.

What To Expect After Surgery

Recovery may take 2 to 4 weeks,
depending on the extent of surgery.

Why It Is Done

Mohs micrographic surgery may be used
for removal of skin cancer that:

  • Is likely to return. Mohs micrographic surgery
    is more effective in obtaining cancer-free margins for cancers that have
    irregular borders and a history of removal and recurrence.
  • Is
    located in visible areas or areas where skin tissue should be preserved, such
    as on the ears, nose, or eyelids.
  • Is growing
    quickly.
  • Has a high risk of spreading to other parts of the body,
    such as in some
    squamous cell carcinomas.
  • Occurs in
    children.

How Well It Works

Mohs micrographic surgery can be an
effective treatment for skin cancer. This technique preserves as much nearby
healthy skin as possible. It is recommended for squamous cell carcinoma when the highest cure rate is desired while sparing as much healthy tissue as possible.footnote 1 And for basal cell carcinoma, Mohs surgery is the best treatment for sparing healthy tissue and preventing recurrence.footnote 2

Risks

Risks of surgery include:

  • Infection of the
    wound.
  • Scarring.
  • Discomfort or
    pain.
  • Bleeding.

What To Think About

Mohs micrographic surgery is the
best procedure to preserve skin tissue surrounding the cancer. But it requires
special training and equipment. And it is time-consuming and expensive.

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

References

Citations

  1. Grossman D, Leffell DJ (2012). Squamous cell carcinoma. In LA Goldman et al., eds., Fitzpatrick’s Dermatology in General Medicine, 8th ed., vol. 1, pp. 1283-1294. New York: McGraw-Hill.
  2. Carucci JA, et al. (2012). Basal cell carcinoma. In LA Goldman et al., eds., Fitzpatrick’s Dermatology in General Medicine, 8th ed., vol. 1, pp. 1294-1303. New York: McGraw-Hill.

Credits

ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD – Internal Medicine
Kathleen Romito, MD – Family Medicine
Specialist Medical Reviewer Amy McMichael, MD – Dermatology

Current as ofMay 3, 2017