Mohs surgery is performed as an outpatient procedure using local anesthesia. On the day of surgery, you may eat and drink as you normally would. Upon arrival to the physician’s office, you will be brought into a surgery room, and the area with the cancer will be marked with a pen and injected with local anesthesia. The surgeon will then remove the area of cancer that can be seen along with a thin margin of healthy-appearing tissue around the cancer. A bandage is then placed on the defect created by the removal of the cancer. You will wait for approximately 30-60 minutes in the office while the tissue is examined. The surgeon will examine your tissue by processing it a special way and placing the margins, or all outside and deep edges of the tumor, onto a slide so that it can be viewed under the microscope. The surgeon then examines this slide under the microscope to determine if there is still cancer present at the edge of the removed tissue. Any areas that still have cancer present are marked on a map, and another thin layer of tissue is removed by the surgeon in these areas. You are given more local anesthesia before this happens, so that you should not feel anything. This process is repeated until there is no more cancer present.
After all your cancer has been removed, the Mohs surgeon will then discuss the methods of repairing the area. In most cases, your repair will take place the same day as your surgery. You will go home with a bandage and detailed instructions on how to take care of your surgical site.
This process can be time-consuming, as each layer taken requires at least 30-60 minutes of time to examine. Therefore, it is recommended to anticipate spending the entire day at the office for your procedure. Most cases, however, do not last more than a few hours. You may feel free to bring food and beverages with you to the procedure as you are free to eat and drink as you normally would.