Mohs Surgery
Mohs skin cancer surgery is the single most effective technique for removing basal cell carcinoma and squamous cell carcinoma, the two most common skin cancers. It accomplishes this by sparing the greatest amount of healthy tissue. Dermatology Medical Group of San Francisco’s experienced physicians sometimes perform Mohs surgery on early or superficial melanomas, depending on their type and location.
Our dermatologists have completed hundreds of Mohs surgeries. A thorough examination, including biopsies, and a detailed medical history will determine your candidacy for this procedure.
Advantages of Mohs Micrographic Surgery
The size of the wound is smaller with Mohs surgery, and this allows for a faster recovery and fewer Mohs surgery scars. Due to the high precision of the procedure, it is perfect for removing skin cancer in areas that are especially sensitive or where scarring is particularly undesirable. These areas include the face (nose, eyelids, lips, and hairline), hands, feet, and genital areas.
Mohs surgery also significantly reduces the chance that skin cancer will recur. Studies have shown that patients who undergo Mohs surgery are more likely to be cured than patients who undergo other types of skin cancer surgery.
Do you suspect you may have skin cancer? Learn about Skin Cancer Detection at our offices.
Skin Cancer Types and Mohs Surgery
Mohs surgery is most commonly used to remove basal cell carcinoma and squamous cell carcinoma, the most common types of skin cancer. Mohs surgery can also sometimes be used to eradicate melanoma, the most serious form of skin cancer.
Ninety percent of skin cancer cases are basal cell carcinoma, which is a non-spreading kind of cancer. Therefore, it is usually easy to treat.
Squamous cell carcinoma is skin cancer that forms in the squamous cells, which are on the surface of the skin. This kind of skin cancer, which also does not spread, is more common in men and in people with fair skin. It is often found on the ears after they have been frequently exposed to sunlight.
Melanoma is the type of skin cancer that spreads to other areas of the body. If detected early, there is a 99 percent chance of survival. If the disease has become advanced, however, it can cause death. One person dies every hour from melanoma, so early detection is vital.
What to Expect from Mohs Skin Cancer Treatment
A local anesthetic is used to numb the tumor site. The cancer cells are then scraped gently with an instrument called a curette. Each tissue section is examined under the microscope, a process that takes approximately one hour.
After the tissue is examined, your surgeon can tell if cancer is still present, in which case another thin layer of tissue must be removed until all of the cancer cells have been eliminated.
Surgeons trained in Mohs micrographic surgery are also trained in reconstruction techniques to minimize scarring. In some cases, BOTOX injections may be helpful during the healing process to improve the appearance of Mohs surgery scars.
Contact our office at (415) 362-2238 to find out more about Mohs surgery in San Francisco.
What Happens During Mohs Surgery?
When doing Mohs surgery, a skilled dermatological surgeon will remove one very thin layer of tissue at a time, checking the tissue margins under a microscope for the presence of skin cancer cells. The procedure ends once the last tissue layer is free of cancerous cells.
Mohs micrographic surgery’s precision gives it the highest cure rate of all skin cancer treatments. Its minimally invasive nature also allows us to save more healthy tissue, resulting in a smaller scar and better cosmetic outcomes than other skin cancer removal techniques. Recovery times are shorter, and there is less risk of disfigurement.
The Mohs Skin Cancer Surgery Procedure
Some reconstruction of the area may be necessary if your surgeon must take a considerable tissue sample to remove all skin cancer cells. We can usually perform this reconstruction immediately after your Mohs surgery to help the area appear as normal as possible. In some cases, reconstruction involves skin grafts – taking some skin from a part of your body that usually hides under clothing and grafting it onto the skin cancer removal site.
Surgeons typically perform Mohs surgery using local anesthetic and oral sedation. No two patients are the same, so the length of the surgery varies depending on the amount of tissue we must remove. We can’t determine this until we examine each layer of tissue under the microscope.
Mohs Surgery Recovery
If you have minimal skin cancer, you may be able to return to work the day after your surgery. You might need more time off if your surgery was more extensive. We will discuss this with you before your procedure.
Most patients experience swelling and bruising for about a week after the surgery. If you have tissue removed from your face, sleep with your head elevated for a few nights, and use an ice pack to reduce swelling. Non-prescription medication such as Tylenol should be sufficient if you experience postoperative pain. Avoid medications with aspirin, such as ibuprofen, as they can cause bleeding.
We will examine you during follow-up appointments to make sure that you are healing properly.
Do you think you might need Mohs surgery for skin cancer? Call us today for an appointment.
San Francisco Mohs Skin Cancer FAQs
Why is Mohs surgery such an effective treatment?
Because the surgeon evaluates 100% of the tissue margins during the procedure, Mohs surgery has the highest cure rate of all skin cancer treatments. It also minimizes the removal of healthy skin.
How long does Mohs surgery take?
Removing each separate layer and analyzing it for cancerous cells may take several hours. Since this varies by patient, plan to spend most of your day in our San Francisco dermatology clinic, even though many surgeries take less time.
Will I be awake during the procedure?
Yes. We use local anesthetic and oral sedation to numb the treatment area while allowing you to remain awake and comfortable.
Is Mohs surgery painful?
Most patients feel only the initial pinch of the numbing injection. After that, you shouldn’t feel discomfort during your procedure. Mild soreness afterward is common and usually manageable with OTC pain relievers that do not increase bleeding risk.
Should I bring anything with me?
You’ll have downtime while we examine the removed tissue. Many patients bring snacks and work or entertainment options to occupy their time while they wait.
How large will my scar be?
Any surgery will leave a mark, but Mohs surgery removes the smallest amount of healthy tissue, which often results in a smaller, more refined scar compared to other techniques.
Will I need stitches or reconstruction?
It depends on the size and location of the surgical site. Some wounds heal naturally, while others require stitches, skin flaps, or grafts. In many cases, we can perform reconstruction immediately after completing Mohs surgery. Your physician will recommend the best approach for your situation.
Can I drive myself home after Mohs surgery?
Typically, yes, but this depends on the surgical site, your comfort level, and the anesthesia type used. Your physician will advise you.
Will I need aftercare?
We will provide you with detailed instructions, including how to keep your surgical site clean, when to change dressings, and signs of infection to look for. Follow‑up visits will ensure your recovery goes smoothly.
Is Mohs surgery safe for older adults?
Yes. Because it uses local anesthesia, Mohs surgery is often an ideal solution for older adults or those with specific medical conditions that make general anesthesia risky.
How soon will I know the results?
A same-day resolution is an advantage of Mohs surgery. You will not leave until your physician has removed and examined all cancerous tissue.
Will I need follow‑up appointments?
Yes. Follow‑up visits allow your physician to monitor healing and check for any signs of recurrence or new skin cancers.
How can I reduce my risk of future skin cancers?
Your dermatologist will recommend a personalized prevention plan that includes medical-grade sun protection products and annual dermatological exams to monitor new or changing lesions.
