Mohs Surgery | The Office of Dr. Vincent Hung
If you are scheduled for Mohs surgery, it is completely normal to feel nervous about what will happen when you arrive. Understanding your surgical plan on the day of your surgery can help you feel more prepared for what lies ahead, especially if your skin cancer treatment is on the face, lips, eyelids, or another area where precise removal and reconstruction matter. This blog will act as a step-by-step guide on what to expect on the day of your Mohs surgery.
Table of Contents
- What to Know Before the Day of Your Mohs Procedure
- Step 1: Check-In and Surgical Preparation
- Step 2: The First Layer of Tissue Is Removed
- Step 3: You Wait While the Tissue Is Processed
- Step 4: The Tissue Is Examined Under a Microscope
- Step 5: Additional Layers Are Removed Only if Needed
- Step 6: Reconstruction or Wound Repair Is Planned
- Step 7: Receiving Post-Operative Instructions
- Choosing the Right Mohs Surgery Provider in Pasadena
- FAQ About the Day of Mohs Surgery
What to Know Before the Day of Your Mohs Procedure
Mohs surgery involves removing the visible tumor and the thin rim of tissue surrounding it. This tissue is then marked, mapped, and evaluated before any additional tissue is removed. If any additional cancer cells are discovered beyond the removed tissue, additional tissue is continuously removed until the surrounding area is completely free of remaining cancer cells.
Because Mohs surgery is performed in stages, the total appointment time can vary. While most procedures take around four hours, it’s recommended that you plan as if surgery could take all day.
You should arrive with your schedule clear, your medication list available, and your post-operative plans already arranged. If your surgery is near the eye, if you feel anxious, or if you expect a larger repair, having someone drive you home may make the day easier.
Step 1: Check-In and Surgical Preparation
When you arrive for Mohs surgery, the team will confirm your information, review the treatment site, and prepare you for the procedure. The surgical site is cleaned and marked before local anesthesia is used to numb the skin.
This first step helps make sure the correct area is treated and that you are comfortable before tissue removal begins. Once the area is numb, you may feel pressure, but you should not feel sharp pain during the removal.
Mohs surgery requires careful planning because Dr. Hung removes tissue precisely and tracks the origin of each section.
Step 2: The First Layer of Tissue Is Removed
After the area is numb, your surgeon removes the visible skin cancer along with a thin layer of surrounding tissue. This layer is intentionally conservative, as Mohs surgery is designed to remove cancer while preserving as much healthy skin as possible.
This is one of the biggest differences between Mohs surgery and standard excision. Instead of removing a wider margin and waiting for outside pathology results, Mohs allows the surgeon to evaluate the tissue during the appointment and continue treatment only where cancer cells remain.
Step 3: You Wait While the Tissue Is Processed
After each layer is removed, the tissue is examined under a microscope while the patient waits. A temporary bandage is placed over the area while the tissue is processed and examined. This analysis is often the longest part of the procedure, typically taking an hour between stages.
It may help to bring a book, headphones, a phone charger, or another quiet activity to help pass the time. Patients can also use the restroom or have a snack while waiting, but they should not leave until the procedure is complete.
The waiting period can feel stressful, but it is also what makes Mohs surgery so precise. The tissue map helps identify the exact area that needs additional treatment, if any remains.
Step 4: The Tissue Is Examined Under a Microscope
During the lab review, Dr. Hung and his team examine the edges and underside of the removed tissue. If no cancerous cells remain, the cancer removal portion of the procedure is complete. If cancer cells are still present, they can identify the exact area that needs to be removed.
This step is especially important for skin cancers on visible or delicate areas, such as the face, nose, lips, ears, eyelids, or scalp. Mohs surgery can be especially beneficial when tissue conservation, cosmetic outcomes, and functional concerns are important.
Step 5: Additional Layers Are Removed Only if Needed
If cancer cells remain after the first layer, another thin layer is removed only from the area where cancer persists. The tissue is processed again, and you wait while it is examined.
This process is repeated until the tumor and remaining cancerous tissue are completely removed, allowing the doctor to remove cancer cells while sparing as much healthy tissue as possible.
Some patients need only one stage. Others need more than one stage before the margins are clear. The number of stages you will need depends on your diagnosis, location, and surgical findings.
Step 6: Reconstruction or Wound Repair Is Planned
Once the cancer has been fully removed, the next step is repair. Depending on the size, depth, and location of the wound, Dr. Hung’s reconstruction techniques may involve direct closure, a local flap, a skin graft, or allowing a very small superficial wound to heal on its own. The most appropriate option will be discussed during your initial consultation.
For skin cancers on the head, face, nose, lips, ears, or other visible areas, reconstruction is not just about closing the wound. It is also about protecting function, supporting healing, and helping the repaired area blend as naturally as possible.
Step 7: Receiving Post-Operative Instructions
Before you leave, you will receive instructions for wound care, activity limits, medications, follow-up visits, and symptoms to watch for. Swelling and bruising may occur and persist for a few weeks. It’s important that you avoid strenuous activity or pressure on the treated area to promote proper healing. Follow-up appointments will be scheduled over the following weeks for routine check-ups.
Your instructions will likely include how to keep the dressing clean, when to change bandages, how to manage discomfort, and when to call the office. Our contact page also includes Mohs patient forms, wound-healing information, medication list forms, and wound care instructions for patients if needed.
Following your post-operative instructions can help support healing and reduce avoidable complications. If you notice increasing pain, spreading redness, unusual drainage, fever, or bleeding that does not improve with pressure, contact our office promptly.
Choosing the Right Mohs Surgery Provider in Pasadena, CA
Comprehensive skin cancer treatment should focus on complete cancer removal, healthy tissue preservation, and thoughtful reconstruction when needed. If you’re a skin cancer patient seeking Mohs treatment, Dr. Hung is one of Pasadena’s top plastic and reconstructive surgeons.
Dr. Vincent Hung is triple board certified in Internal Medicine, Dermatology, and Plastic Surgery, as well as fellowship-trained in “Mohs micrographic surgery.” His practice philosophy emphasizes thoughtful pre- and post-operative care to ensure a smooth, comfortable patient experience. Whether it’s Mohs surgery or another treatment, Dr. Hung will ensure your safety, comfort, and voice are prioritized from consultation through recovery.
FAQ About the Mohs Surgery Process
Will I be awake during Mohs surgery?
Yes. Mohs surgery is typically performed using local anesthesia, so you remain awake while the treatment area is numbed.
How long does Mohs surgery take?
The total time varies, as Mohs surgery is performed in stages and depends on the patient’s needs. However, most patients are advised to keep the full day open to dedicate sufficient time.
What should I bring to my Mohs appointment?
You may bring your medication list, insurance information, a phone charger, snacks if allowed, and something quiet to do while waiting, especially during the tissue sample analysis stage.
Will I need reconstruction after Mohs surgery?
You may need reconstruction depending on the size, depth, and location of the treated area. Dr. Hung offers direct closure, local flaps, skin grafts, and natural healing as possible options for very small superficial wounds.
Can I drive myself home after Mohs surgery?
Some patients may be able to drive themselves home, but this depends on the treatment area, the repair, the patient’s comfort level, and Dr. Hung’s recommendations.
Learn More About Mohs Surgery and Skin Cancer Treatment in Pasadena, CA
Knowing what happens on the day of Mohs surgery can help you feel more confident and prepared. From check-in and numbing to tissue analysis, cancer removal, reconstruction, and post-operative care, Dr. Hung’s treatment planning is designed to treat skin cancer with precision while protecting as much healthy tissue as possible.
Scheduling a personal consultation with Dr. Hung is the best way to learn more about Mohs surgery and other skin cancer treatment options in Pasadena. Call (626) 432-5032 or fill out our online contact form to get in touch with us today.
