Mohs Surgery
Precise, Tissue-Sparing Treatment for Skin Cancer
A diagnosis of skin cancer can be overwhelming, but advances in dermatologic surgery have made treatment more precise, effective, and tissue-sparing than ever before. Mohs micrographic surgery is considered the gold standard for treating many common skin cancers because it offers the highest cure rates while preserving as much healthy skin as possible.
At Treiber Dermatology, Mohs surgery is performed by fellowship-trained dermatologic surgeons who specialize exclusively in the diagnosis, removal, and reconstruction of skin cancers. Combining meticulous surgical technique with advanced reconstructive expertise, the physicians at Treiber Dermatology provide comprehensive care from diagnosis through treatment and follow-up—all in one practice.
Whether treating a small basal cell carcinoma on the nose or a more complex recurrent skin cancer, the goal remains the same: complete cancer removal while achieving the best possible functional and cosmetic outcome.
Mohs micrographic surgery is a specialized technique used to remove certain skin cancers one thin layer at a time. Unlike traditional surgical excision, each layer of tissue is immediately examined under the microscope while the patient waits. If cancer cells remain, only the precise area containing residual cancer is removed. This process continues until all cancer cells have been eliminated.
Because every surgical margin is evaluated during the procedure, Mohs surgery offers cure rates of up to 99% for many newly diagnosed skin cancers while preserving the greatest amount of healthy surrounding tissue.
This combination of complete margin evaluation and maximal tissue preservation makes Mohs surgery particularly valuable in cosmetically and functionally sensitive areas such as the face, eyelids, nose, lips, ears, scalp, hands, and feet.
Mohs surgery is most commonly used to treat:
- Basal cell carcinoma
- Squamous cell carcinoma
- Certain melanomas (including melanoma in situ in select cases)
- Dermatofibrosarcoma protuberans (DFSP)
- Sebaceous carcinoma
- Other uncommon skin cancers when appropriate
Not every skin cancer requires Mohs surgery. Small, low-risk tumors located on the trunk or extremities may be effectively treated with standard surgical excision or other therapies. The physicians at Treiber Dermatology carefully evaluate each patient’s diagnosis, pathology results, medical history, and the location of the tumor to determine the most appropriate treatment approach.
Because treatment recommendations are individualized, patients can feel confident that surgery is recommended only when it offers a meaningful advantage.
The defining feature of Mohs surgery is that it examines 100% of the surgical margins during the procedure.
With standard excision, the removed tissue is sent to an outside pathology laboratory, where only representative sections of the margins are evaluated. While this approach is highly effective for many skin cancers, it samples only a small percentage of the true surgical margin.
Mohs surgery is fundamentally different. The tissue is processed in a specialized laboratory within the office, allowing the surgeon to examine the entire peripheral and deep margin microscopically. This precise mapping technique identifies the exact location of any remaining cancer cells, allowing only those areas to be removed while leaving healthy tissue untouched.
This meticulous process results in:
- The highest cure rates available
- Maximum preservation of healthy skin
- Smaller surgical defects whenever possible
- Lower recurrence rates
- Improved functional and cosmetic outcomes
Mohs surgery is performed comfortably in the office using local anesthesia. Patients remain awake throughout the procedure and are able to return home the same day.
The surgery occurs in stages. After the visible skin cancer is removed, the tissue is carefully processed and examined under the microscope. During this time, patients relax in the office while the laboratory prepares the specimen.
If microscopic cancer cells remain, the surgeon removes another thin layer only from the precise area where residual tumor is identified. This process is repeated until the margins are completely clear.
Because each patient’s tumor behaves differently beneath the surface of the skin, it is impossible to predict exactly how many stages will be required. Some skin cancers are completely removed in a single stage, while others may require additional layers.
Patients should plan to spend several hours in the office on the day of surgery to allow adequate time for tissue processing and careful microscopic evaluation.
Once the skin cancer has been completely removed, attention turns to repairing the surgical wound.
Every reconstruction is individualized based on the size and location of the defect, surrounding skin characteristics, and the patient’s goals. Depending on the situation, the wound may be allowed to heal naturally, closed with a simple linear repair, or reconstructed using advanced techniques such as local skin flaps or grafts.
The fellowship-trained dermatologic surgeons at Treiber Dermatology have extensive experience performing reconstructive procedures following Mohs surgery. Their expertise allows them to restore both function and appearance while carefully respecting the natural contours of the face and body.
Whenever possible, incisions are thoughtfully designed to follow natural skin lines and cosmetic subunits, helping scars heal as inconspicuously as possible.
Mohs surgery is performed by dermatologists who complete an additional year of highly specialized fellowship training after finishing dermatology residency.
During this intensive fellowship, surgeons receive advanced education in skin cancer removal, microscopic pathology, reconstructive surgery, and complex facial reconstruction. They develop expertise not only in removing skin cancer but also in interpreting pathology slides in real time and performing the intricate repairs that often follow surgery.
This unique combination of surgeon and pathologist is what distinguishes fellowship-trained Mohs surgeons from other physicians performing skin cancer procedures.
Because skin cancers frequently develop on the face and other cosmetically sensitive areas, this specialized training is invaluable in achieving excellent long-term outcomes.
Most patients experience only mild discomfort following Mohs surgery, which is typically well controlled with over-the-counter pain medication.
Detailed wound care instructions are provided after the procedure, and follow-up visits are scheduled to monitor healing and remove sutures when appropriate.
Although every patient heals differently, scars generally continue to mature and improve over many months. The physicians at Treiber Dermatology carefully follow patients throughout the healing process and, when appropriate, may recommend additional treatments such as laser therapy or scar optimization techniques to further improve cosmetic results.
Mohs Surgery at Treiber Dermatology
Mohs surgery represents the highest standard of care for many skin cancers, but successful treatment extends beyond simply removing the cancer. It requires thoughtful surgical planning, precise microscopic evaluation, meticulous reconstruction, and long-term surveillance.
At Treiber Dermatology, patients benefit from comprehensive care delivered by fellowship-trained dermatologic surgeons using the most current evidence-based techniques. The practice combines academic expertise with a personalized approach, ensuring that each patient receives individualized treatment focused on complete cancer removal, preservation of healthy tissue, and the best possible cosmetic and functional outcome.
From initial diagnosis through reconstruction and follow-up, patients can feel confident knowing they are receiving expert care close to home in Westchester County.
