Skin cancer surgery removes a skin tumour, such as a basal cell or squamous cell carcinoma, with a margin of healthy skin. The aim is to remove the cancer completely preserving function and appearance as far as possible; your care team decides whether further treatment is needed.
In a standard excision, the surgeon removes the lesion with a safety margin and sends it to pathology to check the edges. Mohs micrographic surgery takes the tumour off in thin layers, examining each under the microscope on the spot until the margins are clear, which spares healthy skin; it is often chosen for delicate areas such as the face. Most procedures use local anaesthesia, and the wound is closed with stitches, a flap or a graft.
Standard surgery usually takes under an hour, while Mohs can occupy much of the day because of waits between layers. Most patients go home the same day and resume their routine within days, with dressing changes and stitch removal at roughly one to two weeks. The scar’s final appearance can be judged only after several months.
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It removes the tumour and allows its edges to be analysed to check that it has been fully taken out. Mohs also aims to preserve as much healthy tissue as possible.
People with a confirmed or suspected skin cancer that can be removed surgically. Your dermatologist or surgeon chooses between standard excision and Mohs according to the tumour’s type, size and location.
A biopsy and a skin check are usually done first. Tell your doctor about all your medicines, especially blood thinners, and do not stop any of them on your own: that is your doctor’s decision. Fasting is not usually needed with local anaesthesia.
Usually under local anaesthesia, the tumour is removed with a margin of healthy skin. In Mohs it is taken off layer by layer, with each layer examined under the microscope until the margins are clear; the wound is then closed.
A standard excision is analysed after the operation, whereas Mohs checks the margins during the procedure itself. Mohs is usually reserved for delicate areas or tumours with a higher risk of recurrence; your specialist will advise you.
Some discomfort, swelling or mild bruising for a few days is common. Keep the wound clean and covered as instructed, and avoid strenuous effort and direct sun on the area.
The pathology report arrives within days to weeks and shows whether the margins are clear. Anyone who has had a skin cancer can develop others, so regular check-ups and sun protection are needed.
They include bleeding, infection, poor healing, visible scarring, altered sensation and sometimes recurrence of the tumour. Your surgeon will explain the risks in your case.
Yes, a scar is to be expected, with its length and appearance depending on the size and site of the wound. It usually fades over the months, and closure with a flap or graft can change its shape.
Depending on the case, a few days to a week is usually enough for the first dressing change and wound check; with a flap or graft it may be somewhat longer. The treating doctor confirms when it is safe to fly.
