Mohs micrographic surgery removes skin cancer in thin, carefully mapped layers. During the Mohs procedure, each layer is examined under a microscope before any additional tissue is removed. This process allows the surgeon to trace remaining cancer cells while preserving as much healthy skin as possible. Learn more about the practice’s broader Mohs surgery services.
At West Virginia Dermatology and Skin Surgery Center, the procedure is performed by Dr. David W. Judy, who is board-certified in dermatology and Mohs micrographic surgery. He is also fellowship-trained in Micrographic Surgery and Dermatologic Oncology. Dr. Judy and our team provide specialized skin cancer care in South Charleston, West Virginia.
What Happens During Mohs Surgery?
Skin cancer can extend beyond what is visible on the surface. Mohs surgery uses detailed tissue mapping and microscopic examination to locate these remaining cancer cells without unnecessarily removing healthy surrounding skin. The procedure is completed in stages, and you remain in the office while each tissue layer is prepared and examined.
The process generally includes:
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Numbing the treatment area: Local anesthesia is injected around the skin cancer, allowing you to remain awake while the area stays numb.
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Removing the visible growth: Dr. Judy removes the visible portion of the tumor along with a thin layer of surrounding tissue.
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Mapping the tissue: The removed layer is divided into sections, marked with dyes, and mapped so each piece can be traced to its exact location on your skin.
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Examining the margins: The tissue is prepared on microscope slides. Dr. Judy examines the edges and undersurface for remaining cancer cells.
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Removing another layer when needed: If cancer is still present, Dr. Judy returns to the specific area shown on the map and removes another thin layer.
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Confirming clear margins: These steps continue until the examined tissue no longer contains cancer cells.
This mapping process is what distinguishes Mohs surgery from a standard excision. Additional tissue is removed only where cancer remains rather than taking a wider margin around the entire site.
Will You Be Awake During the Procedure?
Mohs surgery is typically performed in the office using local anesthesia. You’ll remain awake, but the treatment area will be numb. Using local anesthesia avoids the recovery associated with general anesthesia and usually allows you to return home after the procedure.
You’ll spend part of your visit waiting while each tissue layer is processed and examined. It’s difficult to know beforehand how many stages will be needed because the visible growth doesn’t always show how far the cancer extends beneath the skin. Many tumors are cleared within one to three stages, although more may be necessary.
How Long Does the Mohs Procedure Take?
Most Mohs procedures are completed in one day, but the total time varies. The size, depth, location, and growth pattern of the cancer all affect how many stages are required. Tissue preparation and microscopic examination also take time between stages.
Plan to keep your schedule open for the day rather than arranging work, errands, or other appointments immediately afterward. Although the surgical portions may be relatively brief, the full visit can last several hours.
What Happens After the Cancer Is Removed?
Once the margins are clear, Dr. Judy examines the surgical wound and discusses how it should heal. A small wound may be allowed to close naturally. Other areas may be repaired with stitches, a skin flap, or a skin graft.
The final repair can’t always be planned in full before surgery because the extent of the tumor isn’t known until all cancerous tissue has been removed. When reconstruction is needed, it is commonly completed during the same visit. You’ll receive instructions for bandage changes, cleaning the area, activity restrictions, and follow-up care.
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Why Choose Dr. Judy for the Mohs Procedure in South Charleston?
Dr. Judy performs the surgical removal, microscopic tissue examination, mapping, and wound reconstruction involved in Mohs surgery. His fellowship training included added education in skin cancer pathology, procedural dermatology, and reconstruction.
As a board-certified Mohs surgeon and member of the American College of Mohs Surgery, Dr. Judy can manage each stage of the procedure within one coordinated setting. This continuity supports careful cancer removal while keeping the preservation of healthy tissue, function, and the resulting repair in view.
Discuss Your Mohs Procedure With Dr. Judy
Knowing what will happen during Mohs surgery can make the day feel more manageable. Contact us to request an evaluation with Dr. David W. Judy at West Virginia Dermatology and Skin Surgery Center in South Charleston, WV. Call (304) 925-7546 to speak with the office.