Mohs Surgery, Skin Cancer | The Office of Dr. Vincent Hung
Being diagnosed with skin cancer can be overwhelming, leaving you with many questions about what comes next. One of the most important decisions is choosing the best treatment for your diagnosis: Mohs surgery or standard excision.
Both procedures are designed to remove skin cancer, but they use different techniques. The right option depends on several factors, including the type of skin cancer, its location, its aggressiveness, and the amount of healthy tissue to be preserved. In this blog, we will discuss the differences between Mohs surgery and standard excision, the benefits of each approach, and how to determine which treatment may be right for you.
7 Min Read:
Table of Contents
- What’s the Difference Between Mohs Surgery and Standard Excision?
- When Standard Excision May Be Appropriate
- When Mohs Surgery May Be the Better Choice
- What to Expect During Standard Excision
- What to Expect During Mohs Surgery
- Recovery After Standard Excision
- Recovery After Mohs Surgery
- Why Dr. Hung Is the Top Surgeon for Skin Cancer Surgery in Pasadena
- FAQ About Mohs Surgery vs Standard Excision
What’s the Difference Between Mohs Surgery and Standard Excision?
Standard excision is a procedure that removes the visible skin cancer along with a margin of surrounding skin. The tissue is then sent to a lab, where the margins are checked for cancer cells. This is the most common treatment for basal cell carcinoma.
Mohs surgery works differently. During Mohs surgery, Dr. Hung removes the visible cancer and a thin layer of surrounding tissue, examines that tissue under a microscope, and repeats the process only where cancer cells remain. This procedure allows Dr. Hung to see where the cancer stops during treatment, which helps preserve as much healthy skin as possible.
When Standard Excision May Be Appropriate
Standard excision may be appropriate for early, low-risk skin cancers in areas where a small tissue margin can be removed safely. It’s an effective treatment for curing many early basal cell carcinomas or melanomas.
Standard excision may be considered when the cancer is:
- Small and low risk
- Clearly defined
- Located in an area with more available tissue
- Less likely to affect appearance or function
- Not recurrent or aggressive
If cancer cells are found in the margins after excision, additional treatment may be needed, which may include another excision, Mohs surgery, medication, or radiation therapy.
When Mohs Surgery May Be the Better Choice
Mohs surgery is often recommended for skin cancers that have a higher risk of returning, are large or aggressive, have unclear borders, or appear in areas where tissue preservation is important. It’s a tissue-conserving method that progressively removes affected tissue until only cancer-free skin remains, preserving healthy tissue while allowing complete cancer removal.
Mohs may be especially worth discussing if your skin cancer is:
- On the face, nose, lips, ears, eyelids, or scalp
- Recurrent after previous treatment
- Aggressive or fast-growing
- Large or difficult to clearly define
- In an area where scarring or tissue loss may affect function
- A basal cell carcinoma or squamous cell carcinoma in a higher-risk location
What to Expect During Standard Excision
During standard (traditional) excision, the surgical site is numbed with local anesthesia. Then, your surgeon removes any visible skin cancer along with a small amount of surrounding skin, called a margin, to address any cancer cells that may extend beyond what can be seen on the surface.
After removal, your tissue is sent to a lab for microscopic review to determine whether cancer cells remain at the edges. If the margins are clear, treatment may be complete. If some cancer cells remain, additional treatment may be recommended.
What to Expect During Mohs Surgery
Mohs surgery is also performed with local anesthesia. Using a scalpel, Dr. Hung removes your visible tumor as well as a thin rim of tissue around the affected site. The tissue is then dyed for orientation, mapped, processed, and examined. Any remaining cancerous tissue that is found will be repeatedly removed from the area until the tumor is completely gone.
After the cancer has been treated, the tissues will be replaced to prevent large, unappealing holes around your face or body. Dr. Hung performs varying degrees of reconstructive surgery depending on the wound size, location, and depth. Skin or cartilage grafts may be harvested from areas of your body with excess tissue and carefully reattached, sculpted, and blended with your natural features. Stitches are sewn to close the wound.
Recovery After Standard Excision
Following standard excision, you can expect mild swelling, bruising, tenderness, or tightness around the treatment area during the first several days. Most patients feel comfortable returning home shortly after the procedure, but proper post-operative care is crucial for healing, comfort, and scar management.
If stitches were used, they are typically removed during a follow-up visit, often within two weeks after surgery, depending on location and the surgeon’s instructions. Other post-operative instructions may include:
- Keeping the area clean
- Maintaining your surgical dressings
- Avoiding pressure and stretching that stresses the incision site
- Avoid strenuous exercise for a few weeks
Most wounds and side effects heal within a few weeks. Larger excisions may take longer based on the extent. During your follow-up visit, your surgeon will check the incision, review your healing progress, and communicate whether the pathology results indicate that additional treatment is needed.
Recovery After Mohs Surgery
After Mohs surgery, you may notice some swelling and bruising in the treatment area. However, these side effects should subside within a few weeks after surgery.
During this time, you may be instructed to avoid aspirin or other anti-inflammatory medications for at least three days and strenuous activity for up to three weeks or until cleared by Dr. Hung. If you’re experiencing pain or discomfort, Dr. Hung may recommend TYLENOL® for relief.
It’s also important to avoid lying or sleeping on the side with the treated area. Your follow-up visits will be scheduled over several weeks to monitor wound healing. You should expect some scarring depending on the extent of reconstruction needed and the treatment site, but it can be covered with makeup and fade over time.
Why Dr. Hung Is the Top Surgeon for Skin Cancer Surgery in Pasadena
Skin cancer treatment is not only about removing cancer. It is also about preserving healthy tissue, protecting function, and planning for reconstruction when needed to achieve the best possible aesthetic outcome. For skin cancer patients in Pasadena and surrounding Los Angeles communities, Dr. Vincent Hung is a leading expert on Mohs surgery and skin cancer treatment.
As a triple board-certified plastic and reconstructive surgeon in Internal Medicine, Dermatology, and Plastic Surgery, Dr. Hung offers advanced, comprehensive skin cancer surgical techniques tailored to your needs. Having completed a fellowship for the “Mohs micrographic technique” at the University of Pittsburgh, he holds a unique, nuanced understanding of skin cancer removal. This allows him to address each surgery with careful planning, technical precision, and patient-centered care focused on cancer removal and your final results.
FAQ About Mohs Surgery vs Standard Excision
Is Mohs surgery better than standard excision?
This depends on your skin cancer diagnosis, cancer location, and pathology. Standard excision is more appropriate for certain early, low-risk skin cancers. Meanwhile, Mohs surgery may be the better choice for skin cancers that are recurrent, aggressive, large, difficult to define, or located in areas where preserving healthy tissue is vital.
Does Mohs surgery leave a smaller scar?
For both procedures, your final scar will ultimately depend on the cancer size, depth, location, and reconstruction required. However, Mohs surgery generally provides many patients with ideal aesthetic results, as it removes only affected tissue while preserving as much healthy tissue as possible.
Are there any risks associated with standard excision?
While not common, certain risks associated with standard excision include pain, scarring, numbness, nerve damage, infection, and lymphedema, a swelling in the arms or legs.
Are there any risks associated with Mohs surgery?
Risks for Mohs surgery may include bleeding, tenderness, infection, itching, numbness, large holes around the treated area, or partial removal of the lips if the cancer is located there.
Will I know if all the cancer was removed the same day?
In most Mohs surgery cases, you will know whether the cancer was fully removed the same day. The removed tissue is examined during the procedure, and the process continues until no cancer cells remain. With standard excision, the tissue is sent to a lab after removal, so margin results may take longer.
Schedule a Skin Cancer Surgery Consultation in Pasadena, CA
You don’t have to navigate your skin cancer treatment alone. Whether you’re considering standard excision or Mohs surgery, Dr. Hung will provide you with expert guidance and thoughtful care from consultation through recovery.
To learn more about your skin cancer treatment options in Pasadena, CA, schedule a personalized consultation with Dr. Hung and our team. Get in touch with us by calling (626) 432-5032 or requesting an appointment through our online contact form.
