Mohs micrographic surgery is a specialized treatment that removes skin cancer one thin layer at a time. At West Virginia Dermatology & Skin Surgery Center, Dr. David Judy examines each layer under a microscope and removes additional tissue only where cancer cells remain. This method supports thorough cancer removal while preserving as much healthy surrounding skin as possible.
Dr. Judy is board-certified in dermatology and Mohs micrographic surgery and fellowship-trained in Micrographic Surgery and Dermatologic Oncology. Dr. Judy and our team serve patients in West Virginia at our South Charleston and Barboursville offices.
What Is Mohs Surgery?
Frederic E. Mohs, MD, developed the foundation of the procedure in the 1930s. Today, Mohs surgery combines surgical removal, detailed tissue mapping, and microscopic examination within the same appointment.
The surgeon acts as both surgeon and pathologist. After removing a thin layer of tissue, the surgeon examines its deep and peripheral margins. When cancer cells remain, their location is marked on a map so the next layer can be taken from that specific area rather than removing more tissue around the entire surgical site.
When Is Mohs Surgery Recommended?
Mohs surgery is frequently used for basal cell carcinoma and squamous cell carcinoma. It may also be considered for certain melanomas and less common skin cancers when the technique is medically appropriate.
Your dermatologist may recommend Mohs surgery for a cancer that:
-
Has returned after earlier treatment
-
Has borders that are difficult to see
-
Is large, aggressive, or growing rapidly
-
Appears in an area with limited healthy tissue
-
Develops where preserving function and appearance is especially important
-
Has features associated with a higher likelihood of recurrence
The procedure is often selected for skin cancers around the eyes, nose, lips, ears, scalp, hands, feet, and other areas where tissue conservation matters.
What Is Mohs Micrographic Surgery?
Mohs micrographic surgery is distinguished by the way the removed tissue is mapped and examined during treatment. Rather than sending a sample to an outside laboratory and waiting for results, the surgeon evaluates the margins while you remain in the office.
This allows Dr. Judy to identify small extensions of cancer that may not be visible on the surface. It also helps limit the removal of unaffected skin. Learn more about the treatment, reconstruction, recovery instructions, and common questions on our Mohs micrographic surgery page.
What Happens During the Mohs Procedure?
Mohs surgery is generally completed as an outpatient procedure with local anesthesia. You remain awake, but the treatment area is numb.
The visible tumor and an initial thin layer are removed first. That layer is divided, color-coded, mapped, and examined under a microscope. When cancer remains, another layer is taken only from the location indicated on the map. The process stops once the examined margins are clear.
Because each layer must be processed and reviewed, you should keep the day available. The number of stages and total appointment time depend on how far the cancer extends beneath the skin. Our Mohs procedure page explains each stage in greater detail.
Why Training Matters in a Mohs Surgeon
A Mohs surgeon must understand dermatology, skin cancer pathology, surgery, tissue mapping, wound healing, and reconstruction. The same physician removes the cancer, examines the tissue, determines where additional removal is needed, and plans the repair once the margins are clear.
Dr. Judy completed his Mohs Surgery and Procedural Dermatology fellowship at the University of Massachusetts Medical School. His training supports continuity throughout the procedure, from the initial removal through microscopic examination and reconstruction.
What Happens After the Cancer Is Removed?
Once the margins are clear, Dr. Judy evaluates the size, depth, and location of the wound. A small area may be allowed to heal naturally. Other surgical sites may be closed with stitches, a skin flap, or a skin graft.
The repair method often can’t be finalized before surgery because the full extent of the cancer isn’t known until the microscopic examination is complete. Dr. Judy considers healing, function, surrounding skin, and scar placement when recommending the repair.
Why Choose Dr. Judy for Mohs Surgery in South Charleston?
Dr. Judy is board-certified in dermatology and Mohs micrographic surgery. His fellowship training in Micrographic Surgery and Dermatologic Oncology included experience in skin cancer removal, microscopic tissue evaluation, procedural dermatology, and reconstruction.
At West Virginia Dermatology & Skin Surgery Center, Dr. Judy manages the connected parts of Mohs care within one setting. He removes the cancer, evaluates the mapped tissue, confirms when the margins are clear, and determines how the wound should be repaired.
Request a Mohs Surgery Evaluation
Specialized training is important when cancer removal, microscopic analysis, and reconstruction are completed as parts of the same treatment. Call West Virginia Dermatology & Skin Surgery Center at (304) 925-7546 or contact us to request an appointment with Dr. David W. Judy in South Charleston, WV.