Mohs Surgery Frequently Asked Questions

By Peggy Chern, MD March 9, 2015 8 Comments

mohs surgery FAQ

Mohs Micrographic Surgery is a specialized treatment for certain types of skin cancer that combines the surgical removal and immediate microscopic examination of the tumor and entire surrounding tissue margin.  The technique allows for the immediate identification and removal of the entire tumor layer-by-layer until the cancer is completely gone.

Is Mohs Surgery a new treatment?

No, Mohs Surgery has been performed for decades.  Mohs Surgery is named after Dr. Frederic E. Mohs who developed the technique. Dr. Mohs recognized that skin cancer often resembles the “tip of the iceberg” with tumor cells surrounding the visible tumor that can only be seen under the microscope.  Dr. Mohs treated his first patient using the technique in 1936 at his office in Madison, Wisconsin.  Since then, technical improvements have been made to the procedure; but the general premise has remained the same.

Is Mohs Surgery the best treatment option for all skin cancer types?

Always see your dermatologist if you have any suspicious skin lesions. More than likely your dermatologist will perform a biopsy. If the biopsy tests positive as cancerous, depending on the type and location of the skin cancer (along with other factors) your doctor may recommend Mohs surgery as the best option for treatment. If your current physician does not perform the treatment it is likely you’ll be referred to a Mohs surgeon in your area.

Does Mohs Surgery leave a scar?

All surgical procedures have the potential for some degree of visible scarring.  The appearance of the post-Mohs procedure scar depends on various factors including the location and size of the final surgical defect, the patient’s individual skin characteristics, and available reconstruction options.

A benefit of the tissue-sparing nature of the Mohs technique is to produce the minimum possible surgical defect, thus benefitting the resultant scar. The procedure may allow for smaller and less noticeable scars than other skin cancer removal options.

The Mohs surgeon may be able incorporate suture lines into the patient’s natural skin lines and folds. Most scars improve in appearance naturally over time, and future scar revision techniques may employed if necessary.

If my skin cancer is located in a very noticeable area should I have a plastic surgeon perform the procedure?

It is important to have the skin cancer removed by a fellowship-trained Mohs surgeon due to the histopathology component of the procedure.  A fellowship-trained Mohs surgeon also has extensive training in post-Mohs reconstruction.  If based on the size and location of the surgery there is additional concern regarding the closure, your dermatologist/Mohs surgeon may refer you to a plastic surgeon to perform the closure following Mohs surgery.

What type of training does a Mohs surgeon receive?

After completing a residency in dermatology, a physician can apply to participate in a fellowship training program approved by American College of Mohs Surgery (ACMS) in Micrographic Surgery & Dermatologic Oncology (Mohs).  The fellowship training lasts one to two years, depending on the particular program, with the purpose of safeguarding standards by ensuring that fellows-in-training are properly trained and acquire the necessary expertise to perform Mohs surgery. You may search for a fellowship-trained Mohs surgeon on the ACMS website:  http://www.mohscollege.org/

Will Mohs surgery be covered by my medical insurance plan?

Most insurance plans (including Medicare) will cover Mohs surgery. Contact your insurance company directly to learn more about your specific plan coverage.

Because the Mohs procedure is a multi-step and highly specialized technique, it does tend to have a higher cost than some other treatment options. However, it is important to consider the benefits of Mohs including its lower recurrence rate and ability to spare more healthy tissue.

Learn more about Mohs surgery by downloading our About Mohs Surgery PDF, or visiting the ACMS website at mohscollege.org.


Peggy Chern, MD

Dr. Chern practices dermatologic surgery and procedural dermatology, including Mohs surgery, laser, vein, and cosmetic procedures. She joined Westlake Dermatology in 2009. Dr. Chern is Board Certified by the American Board of Dermatology and is a member of the American Academy of Dermatology, the American Society for Dermatologic Surgery, the American College of Mohs Surgery, the Texas Medical Association, and the Travis County Medical Association.


8 Responses to “Mohs Surgery Frequently Asked Questions”

  1. Jessica says:

    I love Dr. Chern! She’s the best !

  2. I agree with you that a trained surgeon should be the one to do the procedure, even if it does leave noticeable scarring. I always tell our patients that getting rid of cancer is more important than not having scars!

  3. Michael says:

    I wanted to thank you for answering a lot of questions that I had about skin cancer surgery. I had no idea that depending on the type and location of the skin cancer, your doctor may recommend Mohs surgery as the best option for treatment. The other day when I was getting ready for work, I noticed a little mole on my nose, and I think that I should get it checked out as soon as possible. Thanks again for the post!

  4. Carman says:

    I am about the have HOH surgery. The pre-op states that you must not drink for three days before and after and not to smoked 7 days before and after. I was just wondering why?

    • WD Staff WD Staff says:

      Hi Carman,

      Thanks for submitting your great question and for reading our post! Ceasing from alcohol and cigarette use is very important to prevent blood-thinning related complications as well as to ensure proper healing post-procedure. As always, we recommend following all pre and post procedure instructions as given by your provider.

      We wish you a speedy recovery!

      Thanks,
      WD Staff

      • Randy says:

        I had mole and it is basel cancer in between eye and nose, My doctor gave me 4 months wait until MOHS is this normal, Not sure why but looking for answers.

        • WD Staff WD Staff says:

          Hi Randy,

          Thanks for reading our post! Unfortunately it would be difficult to provide an answer without additional medical info and the ability to assess you in person. Did you want to come in for a second opinion? If so please give us a call at 512.328.3376.

          Sorry we can’t be of more immediate help.

          Thanks,
          WD Staff

  5. Michael says:

    I am preparing for a MOHS surgery right now. It is good to know that most MOHS surgeries are covered by medical insurance plans. It is also good to know that most MOHS surgeons can do the reconstruction after by themselves.

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