Mohs Micrographic Surgery at Nebraska Medicine

The Dermatology program at Nebraska Medicine has doctors who have specialized training in Mohs micrographic surgery. This type of surgery is used to treat many types of skin cancer and it has the highest cure rates with the lowest chance of your skin cancer from coming back.

Understanding Mohs surgery

The surgery is performed in the medical office or surgical suite. On the day of your surgery, your surgeon will examine the area to be treated. This includes giving you an injection of an anesthetic medicine. You will be awake and alert during surgery. You will go home after the surgery is done.

During the surgery

A thin section of the skin cancer and a small area around it are removed. The tissue is immediately taken to our on-site pathology lab. All tissue is reviewed under the miscroscope. This process takes approximaly 60 to 90 minutes. It is then repeated. Sections of tissue continue to be removed and looked at under a microscope until no more cancer cells are found.

During standard tumor removal

The skin cancer and a margin of healthy tissue around it are removed all at once. Mohs surgery removes the skin cancer in layers, which allows for smaller wounds and higher cure rates. There is a very low chance of the cancer coming back and with this type of surgery it allows you to keep as much healthy skin as possible because the surgeon only removes the skin with cancer cells.

After tumor removal

When the skin cancer has been completely removed, wound repair, known as reconstruction, will be discussed with you. Most times, the wound repair is done by your Mohs surgeon. Some patients are referred to another surgeon for wound repair. 

When is Mohs surgery is done

Mohs surgery is most often used for skin cancer that is:

• Large, fast-growing aggressive skin cancers
• Likely to spread
• Likely to come back. Or has come back already
• On an area where it is important to remove as little tissue as possible (examples, eyelid, nose, ears)

What to expect the day of surgery

• Depending on the location of the skin cancer, you may need to change into a gown
• The area around the skin cancer is injected with an anesthetic. This medicine numbs the area and prevents pain
• The surgeon removes the first layer of tissue. The area is covered with a small bandage
• You may move into a waiting area
• The tissue is examined. This can take up to an hour or longer. During this time, you can read or watch TV
• You may return to the surgery room to have more of the skin cancer removed
• This process is repeated until the tissue that is removed shows no more cancer cells
• Once all of the skin cancer is removed, you and your surgeon will decide on how best to repair the wound. The repair may be done right away or the surgery may be scheduled for another day

If questions or concerns please call Nebraska Medicine Dermatology at 402-552-7928.