Your Step-by-Step Guide to Mohs Surgery

Since skin cancer is the most common type of cancer in the United States, it makes sense that medical researchers have spent extensive time discovering and refining treatment options. 

Today, if you have skin cancer that can’t be effectively treated by a basic biopsy, Mohs surgery gives you an extremely precise way to address it. With this targeted procedure, we can remove the cancerous cells while protecting as much of the surrounding area as possible. 

Mohs surgery is highly effective, with up to a 99% five-year cure rate for primary basal and squamous cell carcinoma. One study found that it delivered a 100% disease-specific survival rate to people with invasive melanoma. 

Because it’s the gold standard in skin cancer treatment, Ali Hendi, MD, and Joanna Dong, MD, specialize in this procedure. We offer Mohs surgery to people throughout the Washington, DC, Maryland, and Northern Virginia areas from our comfortable office in Chevy Chase, Maryland. 

If Dr. Dong, Dr. Hendi, or another provider has recommended this type of surgery to you, you’re probably wondering what to expect. Here’s a step-by-step guide to the process.

#1: We numb the area

We’re committed to keeping you comfortable during treatment. As a result, we thoroughly numb the area where we’ll perform your Mohs procedure. You should feel no pain at all during your surgery. 

#2: We remove the top layer

Your provider removes the visible cancerous tissue (i.e., the part of the mole or other growth you can see on your skin). This only takes a few minutes. 

#3: We analyze the removed cells

The removed layer goes to our lab, where we thoroughly analyze it. 

We carefully slice it into cross-sections, which we color-code and use to map the surgical site. We look at each cross-section under the microscope to determine if we’ve removed all of the cancerous cells or if more remain in the deeper layers of your skin. 

This rigorous process usually takes an hour or two. You wait at our office during this time. 

#3: Repeat steps 1 through 3 as needed

If our analysis determines that cancerous cells remain in your skin, we repeat these first few steps. We re-numb the area, if needed, and then carefully remove cells where our map has determined skin cancer remains. 

Say, for example, that our microscopic analysis reveals we’ve removed down to healthy skin cells on the right side of your surgery site, but skin cancer remains on the left portion. Your provider only removes more tissue from the left side of your surgical area, carefully excising based on where we’ve mapped the skin cancer. 

This makes your Mohs surgery more precise, leaving you with the smallest scar possible. 

For most patients, we can remove the cancerous cells in three stages or less. That said, the number of rounds you’ll need during your Mohs surgery completely depends on your skin cancer’s progression. 

#4: We protect the treated area

Once our lab analysis confirms that we’ve removed all the cancerous cells, we decide how to protect your surgery site as it heals. We choose what’s best for your health and cosmetic outcome. 

In some cases, we leave the site open but bandaged. In others, we use sutures or a skin graft to close it. 

#5: You head home

We perform Mohs surgery as an outpatient procedure, meaning you can go home afterward. We send you home with instructions on how to care for the treated area. 

You might have some discomfort or itchiness at your surgery site. For most people, an over-the-counter pain reliever like ibuprofen or acetaminophen is enough to ease any pain. 

You generally need to clear your whole day for Mohs surgery, but it’s an extremely effective way to eradicate skin cancer and you can sleep at home that night.

 To see if this treatment option is right for you or to schedule your procedure, call 301-812-4591 or book an appointment online today.