Mohs Micrographic Surgery

Mohs micrographic surgery is considered to be the most effective technique for treating basal cell carcinomas (BCCs) as well as squamous cell carcinomas (SCCs), the two most common types of skin cancer. This procedure aims to achieve the highest possible skin cancer cure rate and minimizes the size of the wound and consequent distortions at critical sites such as the eyelids, ears, nose, and lips. Mohs micrographic surgery is a two-step, same-day procedure performed with local anesthetic. It involves removing the tumor in stages by histologically confirming clear margins on frozen sections and by addressing the resultant defect. Because a Mohs surgeon is specially trained as a cancer surgeon, pathologist, and reconstructive surgeon, Mohs surgery has the highest success rate of all skin cancer treatment options available – up to 99%.

Options for healing include second intention, primary closure, local flaps, interpolation flaps and grafts. Larger tumors may require reconstructive surgery. Mohs micrographic surgery is the treatment of choice for skin tumors in critical sites, large recurrent tumors, tumors in sites of radiation therapy, and tumors with aggressive histologic features.

Advantages of Mohs Surgery.

  • Ensuring complete removal during surgery, eliminating the chance of the cancer growing back.
  • Minimizing the amount of healthy tissue lost.
  • Maximizing the functional and cosmetic outcome resulting from surgery.
  • Repairing the site of the cancer the same day the cancer is removed.
  • Curing skin cancer when other methods have failed.

Risks Associated With Mohs Micrographic Surgery.

The complications associated with Mohs surgery are very low. However, risks vary between individuals. Listed below are the usual risks associated with Mohs surgery:

  • Scar formation at the site of tumor removal.
  • Larger than expected wound created upon removal of the skin cancer.
  • Poor wound healing, which may be due to the patient’s underlying health conditions or failure of the wound repair method.
  • Excessive bleeding from the wound, which could affect wound healing and/or result in the need for an increased number of office visits.
  • Wound that becomes infected (an uncommon occurrence).
  • Loss of nerve function (muscle or feeling) if a tumor invades a nerve.
  • Regrowth of tumor after removal (more common with previously treated tumors and large, long-standing tumors).
  • Cosmetic or functional deformities if tumor is located near or on a critical site.

Although Mohs micrographic surgery has a high rate of curing skin cancer, patients will always have a small risk of skin cancer recurrence within five years following their treatment. Patients should expect to return for ongoing skin exams once or twice a year to prevent skin cancer reoccurrence; more often if the cancer was aggressive and is likely to reoccur.
To schedule an appointment with Mohs Micrographic Surgeon Dr. Michael Trauner and his team at The Dermatology Center, call (916) 736-3399 or visit