Mohs surgery, also referred to as Mohs micrographic surgery (MMS), is a procedure using both pathology and surgery to remove skin cancers in a physician’s office. Mohs is performed by cutting horizontal pieces of tissue from the bottom layer of the skin tumor. After the precise cut is made, the culture is immediately stained and examined under a microscope. Repeated saucer-shaped layers of tissue are removed and examined until no more skin cancer can be seen in the sample. If more cancer cells are seen under the microscope, tissue is removed at the site of involvement. Once the cancer has been fully removed, we will determine the type of repair for the best cosmetic result.
Mohs micrographic surgery is an outpatient procedure done in a doctor's office under local anesthetic. On the day of your procedure, you should expect to be in the medical office for several hours. Depending on how large or difficult your skin cancer is, more time may be required for complete excision. It is not always possible to predict ahead of time how long the procedure will take. Your doctor will discuss this with you ahead of time.
Depending on the specific patient and tumor type, Mohs surgery may treat any area of the body, but it's primarily used for the treatment of head and neck basal and squamous cell skin cancers. It is also very useful for skin cancers in difficult areas such as the nose, lips, and ears, where it is important to remove a minimal amount of uninvolved tissue. Hands and feet can benefit from MMS as well to minimize scarring. MMS is very effective for the treatment of tumors that were previously removed and have regrown at the same site.