First, the tumor and a thin rim of surrounding skin are removed under local anesthesia. A map is developed and the tissue is divided into pieces and color-coded. The edges and deep margins are mounted on slides and examined under the microscope by the Mohs surgeon. If the tumor is still present, the surgeon removes another thin layer of tissue only in the area where the cancer is located. In this way, the normal healthy tissue is spared. By examining 100% of the skin edges there is an exceptionally high cure rate, greater than 99.5% for previously untreated tumors. Once the tumor is completely removed, the area is repaired using advanced cosmetic techniques to insure the optimal cosmetic result.
Mohs surgery is the most effective and precise method of treating skin cancer. Microscopic examination allows the surgeon to save as many healthy cells as possible while removing all the cancer cells. The cure rate is greater than 99.5% even with lesions that failed prior treatment. Because Mohs removes the cancer with the greatest certainty, elegant reconstructions can be performed for the best cosmetic outcome with the smallest possible scar. The dermatologist should be a member of The American College of Mohs Micrographic Surgery and Cutaneous Oncology, which insures that they have had extensive training in the excision, pathological diagnosis and reconstruction of skin cancers.