Mohs Surgery

Mohs Micrographic Surgery is a highly specialized, tissue-sparing technique used to treat certain types of skin cancer. It is considered the gold standard for treating basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and other select skin cancers, especially those located on the face, ears, scalp, hands, or other cosmetically and functionally sensitive areas.

What sets Mohs Surgery apart is its precision. Unlike traditional excision, Mohs allows for 100% microscopic examination of the tissue margins during the procedure. Cancerous tissue is removed in thin layers, and each layer is examined immediately under a microscope in an on-site lab. This process is repeated until no cancer cells remain, ensuring complete removal while preserving as much healthy tissue as possible.

With cure rates up to 98% for BCC and SCC, Mohs Surgery offers the highest success rate of any skin cancer treatment. It is particularly beneficial for tumors that are aggressive, recurrent, or located in areas where cosmetic outcome is a priority.

Developed by Dr. Frederic E. Mohs in the 1930s, the technique has become a global standard in skin cancer care. It is especially effective in identifying and removing cancer cells that extend deeper than they appear on the surface, often growing along nerves, blood vessels, or cartilage. At Charlotte Dermatology, Mohs Surgery is performed in-office as an outpatient procedure using local anesthesia. The process is meticulous but efficient, and patients are encouraged to set aside the full day in case multiple stages are required.

The procedure involves three main steps:

1. Tissue Removal: After numbing the area with local anesthesia, the visible tumor is removed along with a thin layer of surrounding tissue. A detailed map of the excised tissue (a “Mohs map”) is drawn to track where each section came from.
2. Microscopic Examination: The tissue is color-coded and processed in our on-site laboratory. A technician freezes the specimen, slices it thinly, and places it on slides for microscopic examination. This step takes time—often an hour or more—as it involves reviewing the entire edge and underside of the tissue.
3. Targeted Removal (if needed): If cancer cells are still detected, only the precise areas where cancer remains are re-excised. This step is repeated until all tissue margins are clear, minimizing the removal of healthy skin and reducing the size of the final wound and scar.

Reconstruction and Recovery:

Once the cancer has been fully removed, reconstruction is performed the same day. Depending on the wound's size and location, this may involve sutures, skin flaps, or grafts. Patients typically experience mild swelling or bruising, and stitches are removed at a follow-up visit. Most individuals can return to normal activities within a few days.

Dr. El-Gamal at Charlotte Dermatology ensures both medical and cosmetic outcomes are carefully addressed. Comprehensive aftercare instructions are provided, along with guidance on sun protection to help reduce the risk of future skin cancers.

Mohs Surgery is available at our Charlotte-area clinics, including SouthPark and University City, where patients receive expert, personalized care from providers with advanced training in skin cancer treatment.