Mohs Surgery

Step 1

The roots of a skin cancer may extend beyond the visible portion of the tumor. If these roots are not removed, the cancer will recur. A surgery starts with the American College of Mohs Surgery (ACMS) specialist examining the visible lesion and planning what tissue to remove. The patient then receives local anesthesia, and the Mohs surgery begins.

Step 2

The surgeon removes the visible portion of the tumor using careful surgical techniques.

Step 3

The ACMS surgeon next removes a deeper layer of skin and divides it into sections. With the help of technicians, the surgeon then color-codes each
of these sections with dyes and makes reference marks on the skin to show the source of the sections. A map of the surgical site is then drawn to
track exactly where each small portion of tissue originated.

Step 4

In a laboratory, the surgeon uses a microscope to examine the undersurface and edges of each section of tissue in search of evidence of remaining
cancer.

Step 5

If the surgeon finds cancer cells under the microscope, he or she marks their location on the "map" and returns to the patient to remove another
deeper layer of skin — but only from precisely where the cancer cells originated. This method ensures that the Mohs surgery results in the smallest scar possible.

Step 6

The removal process stops when there is no longer any evidence of cancer in the surgical site. Because Mohs surgery removes only tissue containing
cancer, it ensures that the maximum amount of healthy tissue is kept intact.

At this point, the surgeon discusses reconstruction options, should they be required, and then post-operative care. Mohs surgery recovery tends to be easily manageable because of the use of local anesthesia and the careful surgical techniques.

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Helpful link

• American College of Mohs Surgery