Mohs Surgery

At Lockhart Matter Dermatology, serving patients in Plano, Prosper, and the broader Dallas area, our mission is to provide state-of-the-art dermatologic care with compassion and precision. One of the most effective treatments we offer for certain kinds of skin cancer is Mohs micrographic surgery. Below is a thorough overview of what Mohs surgery is, how it works, how successful it is, and when it is used. If you have concerns about skin cancer or have been diagnosed and want to know whether Mohs is right for you, we can help you understand your options.

What is Mohs Surgery?

Mohs surgery (also called Mohs micrographic surgery) is a highly specialized technique used to remove skin cancers. What makes it different is that the surgeon removes the cancer layer by layer, and each layer is examined under a microscope immediately. This allows the surgeon to see whether any cancer cells remain, and only remove as much tissue as necessary. The goals are to completely remove the cancer while preserving as much healthy skin as possible.

When is Mohs Surgery Recommended for Skin Cancer Treatment?

Mohs surgery is most often recommended when skin cancer appears in areas where both function and appearance are especially important, such as the face, ears, nose, lips, hands, feet, or genitals. In these locations, preserving healthy tissue is critical to maintain both natural appearance and proper function.

It is also the treatment of choice for tumors that are large, aggressive, have poorly defined borders, or belong to more difficult subtypes. Additionally, Mohs is commonly used when a tumor has recurred after previous treatment, as its high cure rate offers the best chance of eliminating the cancer for good. Patients who are immunocompromised, or who have medical conditions that increase the risk of recurrence or complicate healing, may also be ideal candidates for Mohs. In these situations, the precision of Mohs helps maximize cancer control while minimizing unnecessary trauma to healthy tissue.

How is Mohs Surgery Performed?

To perform Mohs surgery, the treatment area is numbed with a local anesthetic, ensuring that the surgery is virtually painless. Because Mohs is almost always performed in an outpatient setting, patients are able to return home the same day.

The process itself is meticulous and highly precise. First, the visible tumor and a thin margin of surrounding tissue are carefully removed. This tissue is then processed and sliced into thin layers for microscopic examination. During examination, if cancer cells are detected at the edges, another tissue layer is removed only from the affected area. This process is repeated until no cancer cells remain.

When the cancer has been fully removed, attention turns to reconstruction. Depending on the size and location of the wound, the area may be closed with simple stitches, repaired with a skin graft or flap, or allowed to heal naturally. In many cases, reconstruction is performed the same day. After surgery, patients receive detailed wound care instructions and schedule follow-up visits to monitor healing.

How Effective is Mohs Surgery?

Mohs surgery is widely regarded as the most effective treatment for many forms of non-melanoma skin cancer. For primary basal cell carcinoma (BCC), the five-year cure rate is typically between 97% and 99%, making it one of the most reliable methods available. Even for recurrent BCCs, the cure rate remains impressively high at approximately 94% to 95%. The procedure is also highly effective for squamous cell carcinoma (SCC), where cure rates for primary tumors range from about 92% to 99%. While the success rate may be somewhat lower for recurrent or aggressive SCCs, Mohs remains the preferred treatment in many cases.

One of the primary reasons Mohs is so successful is that it allows for 100% of the surgical margin to be examined under the microscope, compared to traditional excision methods that only sample small portions. This meticulous process greatly reduces recurrence rates while preserving as much healthy tissue as possible.

What is Recovery Like After Mohs Surgery?

Recovery after Mohs surgery is generally smooth, but it can vary depending on the size of the wound, the location of the surgery, and the type of reconstruction performed. Because the procedure is done with local anesthesia, most patients are able to go home the same day and resume light activities shortly after. However, rest is encouraged for the first 24–48 hours to minimize swelling and allow the body to begin healing.

The surgical site will typically be covered with a bandage, and patients receive detailed instructions on how to clean and care for the wound. Mild discomfort, swelling, and bruising are common in the first few days, but these usually improve quickly and can be managed with over-the-counter pain medication. Stitches, if used, are generally removed within one to two weeks, and the area continues to strengthen over the following weeks.

In terms of appearance, it is normal for the treated area to look red, swollen, or slightly raised at first. Scarring is unavoidable with any skin surgery, but Mohs helps minimize this by removing as little healthy tissue as possible. Over time, scars typically fade and flatten, and in some cases may become barely noticeable. Most patients can return to normal routines within a week or two.

Is Mohs Surgery Right for Me?

Mohs surgery is often the best choice if your skin cancer is on a cosmetically or functionally sensitive area (like the nose, eyelids, lips, ears, hands, or feet), if it has come back after prior treatment, has indistinct borders or aggressive features, or if you want to maximize cure rates while preserving as much healthy tissue as possible. It’s commonly recommended for basal cell and squamous cell carcinomas and, in select cases, for melanoma in situ.

The simplest way to know is to have your biopsy and medical history reviewed by a dermatologist trained in Mohs. At Lockhart Matter Dermatology, we’ll compare Mohs with other options—standard excision, electrodesiccation and curettage, topical therapies, or radiation—so you understand the trade-offs and can choose the approach that fits your diagnosis, health, and cosmetic goals.

If you believe you may have skin cancer, or if you have been diagnosed and want to discuss whether Mohs is the best option, the team at Lockhart Matter Dermatology is here to help. Serving Prosper, Plano, and the surrounding areas of Dallas, Texas, and surrounding areas, we have the experience and the care to guide you through your options and produce the best possible outcomes. Contact Lockhart Matter Dermatology today to schedule a consultation and learn if Mohs surgery is right for you.