Question 1

What is the advantage of Mohs surgery over standard excision?

Accepted Answer

Mohs surgery examines 100% of the surgical margins in real-time, compared to standard excision which samples only about 1% of margins. This provides cure rates of up to 99% for primary basal cell carcinomas versus 90-95% for standard excision. Mohs also removes only cancer-containing tissue, preserving maximum healthy tissue - particularly important on the face where every millimeter matters for appearance and function.

Question 2

How long does Mohs surgery take?

Accepted Answer

Most Mohs procedures take 2-4 hours total, but you should plan to be at the office for most of the day. The actual surgery time is relatively short (15-30 minutes per stage), but processing and examining the tissue takes 30-60 minutes per stage. Most cancers are cleared in 1-3 stages. Complex tumors may require additional stages. Reconstruction adds additional time depending on complexity.

Question 3

Is Mohs surgery painful?

Accepted Answer

Mohs surgery is performed under local anesthesia, similar to having a dental procedure. You will feel pressure but not sharp pain during the surgery. Most patients tolerate the procedure very well without sedation. After surgery, discomfort is typically managed with over-the-counter pain medication. The waiting periods between stages are the most challenging aspect for some patients.

Question 4

Will I have a large scar after Mohs surgery?

Accepted Answer

Mohs surgery is designed to minimize scarring by removing only the cancer-containing tissue. Mohs surgeons are trained in reconstructive techniques to optimize cosmetic outcomes. While any surgery leaves some scarring, the results are typically excellent. Most scars continue to improve over 6-12 months. Your surgeon will discuss expected outcomes based on your specific tumor size and location.

Question 5

Can Mohs surgery treat melanoma?

Accepted Answer

Mohs surgery with modified techniques can treat melanoma in situ (early, non-invasive melanoma) in select situations, particularly on the face where tissue conservation is important. However, invasive melanomas typically require wide local excision with standard margins and possible sentinel lymph node biopsy. Your dermatologist will recommend the appropriate treatment based on your melanoma type and stage.

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