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Mohs Surgey

At Cahaba Dermatology we specialize in Mohs surgery, a precise surgical technique utilized for the removal of certain types of skin cancer. Led by our expert dermatologists, our practice is committed to providing exceptional care and achieving optimal outcomes for our patients.

What is Mohs Surgery?

Mohs micrographic surgery is an advanced treatment for skin cancer that offers the highest cure rate while preserving as much healthy tissue as possible. This specialized technique involves removing cancerous tissue layer by layer and examining each layer under a microscope until no cancer cells remain.


  • High Cure Rate – Mohs surgery boasts one of the highest cure rates for skin cancer, reaching up to 99% for certain types of skin cancers.


  • Tissue Preservation – By meticulously removing cancerous tissue while sparing healthy surrounding tissue, Mohs surgery helps minimize scarring and ensures optimal cosmetic outcomes, particularly for cancers located on the face or other sensitive areas.


  • Accuracy – The microscopic examination of each tissue layer allows for precise removal of cancer cells, reducing the likelihood of cancer recurrence.


  • Minimized Risk – Mohs surgery minimizes the risk of leaving cancerous cells behind, thereby reducing the need for additional treatments or surgeries.


Before undergoing Mohs surgery, patients will typically have a consultation with our dermatologist to discuss the procedure, address any concerns, and develop a personalized treatment plan. Some general preparation steps may include:

- Medical History: Provide a comprehensive medical history, including current medications and any allergies.
- Skin Examination: Our dermatologist will perform a thorough examination of the skin to identify the extent of the cancerous lesion.
- Instructions: Follow any pre-surgery instructions provided by our medical team, which may include avoiding certain medications or skincare products.

*Surgical appointments may require an extended duration, often spanning several hours. We kindly ask all patients to be prepared for this possibility. So please wear comfortable attire.

For your comfort during surgery, we provide options such as Pronox or anxiolytics to help you feel more at ease


During Mohs surgery, patients can expect the following:

- Local Anesthesia: The area surrounding the cancerous lesion will be numbed with local anesthesia to ensure a comfortable experience during the procedure.
- Tissue Removal: Our dermatologist will carefully remove the visible portion of the cancerous lesion.
- Layer-by-Layer Examination: Each layer of tissue removed will be examined under a microscope in our on-site laboratory. This process continues until no cancer cells are detected, ensuring complete removal while preserving healthy tissue.
- Closure: Once the cancerous tissue has been fully excised, our dermatologist will discuss options for wound closure, which may include stitches or other techniques to optimize healing and cosmetic results.


After Mohs surgery, patients will receive detailed post-operative instructions to promote proper healing and minimize complications. These may include:

- Wound Care: Carefully follow instructions for wound care, including cleaning the area and applying any prescribed medications or dressings.
- Activity Restrictions: Avoid strenuous activities or anything that could disrupt the surgical site during the initial healing period.
- Follow-Up: Attend scheduled follow-up appointments to monitor healing progress and address any concerns.
- Sun Protection: Protect the surgical site from sun exposure by applying sunscreen and wearing protective clothing.

What Happens During Mohs Surgery?

During Mohs surgery, the procedure is conducted in sequential stages, all completed within a single visit, with intervals for examination and waiting in between. The surgeon begins by removing a layer of tissue, which is then examined under a microscope in a nearby laboratory. If any cancer cells are detected, the surgeon precisely removes another layer of tissue from the identified location, aiming to preserve as much healthy tissue as possible. This process continues until no cancer cells remain.

Step 1: Examination and Preparation

Depending on the location of the skin cancer, the patient may wear street clothes or a hospital gown. The Mohs surgeon assesses the biopsy site, possibly marking it for reference, and positions the patient accordingly. Local anesthesia is administered to ensure complete numbing of the area, allowing the patient to remain awake throughout the procedure.

Step 2: Removal of Top Layer

Using a scalpel, the surgeon removes a thin layer of visible cancerous tissue. However, since some skin cancers may have deeper roots, further analysis is necessary to ascertain their extent. The wound is temporarily bandaged, giving the patient time to relax while laboratory analysis takes place.

Step 3: Laboratory Analysis

The excised tissue is sectioned, color-coded, and mapped for reference. In the laboratory, thin horizontal slices are made, stained, and examined under a microscope, a meticulous process that requires time.

Step 4: Microscopic Examination

The surgeon meticulously examines the tissue on microscope slides, marking any remaining cancer cells on the map. Depending on the findings, additional tissue removal may be necessary.

Step 5: Removal of Subsequent Layers

If further tissue removal is required, the surgeon administers more anesthesia and precisely excises the identified areas of cancerous cells. Meanwhile, laboratory analysis recommences. This iterative process continues until all cancer cells are eliminated.

Step 6: Wound Repair

Once the site is clear of cancer cells, the wound may be left to heal naturally or closed with stitches, depending on its size and location. In some cases, complex wounds may require reconstruction using adjacent tissue or a skin graft, sometimes involving coordination with other specialists.

Step 7: Conclusion

The duration of the entire process may vary, potentially lasting several hours. Despite its duration, Mohs surgery offers high cure rates and minimizes scarring by preserving healthy tissue. Adhering to post-operative care instructions is crucial for optimal outcomes.