Mohs micrographic surgery

It is mainly used in cosmetically sensitive areas of the face to minimise the amount of scarring, while also providing the highest cure rates. It was pioneered by an American Surgeon, Dr Frederich Mohs who gave his name to the technique.

What happens during Mohs micrographic surgery?

Mohs micrographic surgery is performed under local anaesthetic. Your consultant will inject local anaesthetic in and around the area of your skin cancer. Once the area is numb they will remove any visible cancer and a thin layer of skin surrounding the tumour.

The tissue that is removed is then processed in a laboratory so that your consultant can examine it under a microscope. This can take up to one hour, during which time you will wait in a comfortable waiting room. If your consultant finds evidence of cancer cells, another layer of skin will be removed, but only in the precise location where the cancer cells were seen. Your consultant will continue to remove small layers of skin until all the ‘roots’ of the cancer are removed.

Mohs micrographic surgery can be lengthy process since each stage must be prepared and carefully examined. The length of your surgery will depend on the extent of your skin cancer. You should therefore prepare to be there all day.

Once your consultant is happy that all the cancerous cells have been removed they will discuss the best way to reconstruct the wound. There are many ways to do this and most of these options will be discussed with you during your pre-operative consultation.

Going home after Mohs micrographic surgery

Mohs micrographic surgery is usually done as a day case meaning you can go home the day of your surgery. You will not be able to drive so please arrange for someone to take you home when you are discharged.

It is likely that you will have a bulky dressing on your wound. Please leave this in place to protect your wound and stop any bleeding. Your consultant will discuss with you how long this need to be kept in place, but commonly it is only needed for the first 24 or 48 hours.

Once the local anaesthetic has worn off the area may be painful. Take over the counter pain relief such as Paracetamol as needed.

You may experience bruising or swelling around your wound. This should ease in a few days.

If you have any stitches you will need to return to our hospital or see your GP have them removed.

Please discuss any return to work with your consultant.

Although the vast majority of cases will be performed without any problems, as with any surgical procedure some of the risks that your consultant will discuss with you include:

• Scarring
• Pain
• Bruising
• Numbness
• Infection
• Bleeding
• Recurrence of the skin cancer (although with Mohs micrographic surgery, the cure rate is the highest of any surgical treatment)

Why not print this treatment page so that you can discuss any concerns you have with your consultant?