What Is Mohs Surgery?

Mohs surgery is a procedure used to remove skin cancer. Because the surgery removes only tissue with cancer cells, it is commonly used on areas of the body where it is important to minimize the removal of healthy tissue. For the eye area, Mohs surgery removes basal cell and squamous cell cancers found on the eyelids or around the eyes.

Basal cell cancers are the most common type of skin cancer. Basal cell cancers grow in the deepest layer of the skin. They are almost always caused by exposure to sunlight. Squamous cell cancers are the second most common type of skin cancer. They grow just below the outer layer of the skin. Both basal cell and squamous cell cancers are best treated when detected early.

Mohs surgery is also sometimes used to remove melanoma, a more aggressive form of skin cancer. But melanoma is more commonly found inside the eye than on the eyelid.

What happens during Mohs surgery?

Mohs micrographic surgery is a special technique that uses a physician's skill, under local anesthesia, to remove skin cancers. In most cases, the surgeon will perform this surgery in their office.

You will be awake during the entire procedure, but your Mohs surgeon can give you medicine to help you relax. The surgeon will first numb the skin around the cancerous area so you cannot feel anything. Then they will remove any suspicious areas with a layer of surrounding tissue. The surgeon examines this tissue under a microscope. If any cancer cells are present, they will remove another adjacent layer. The surgeon repeats the process until they do not detect any cancer cells under the microscope. The surgery usually lasts a few hours.

Because the surgeon examines the tissue they remove, Mohs surgery reduces the need to remove healthy tissue. This surgery is intended to allow for complete removal of the skin cancer while creating a small tissue defect. This allows for improved wound healing and cosmetic results. Your surgeon may also discuss options for reconstructive surgery depending on the size and location of the cancer they removed. If the defect is on the face, eyelids or the eye itself, a specially trained ophthalmologist may assist with this reconstruction.

Following the procedure, your surgeons will monitor you to make sure that you are healing properly.