Mohs Surgery at Hoag
Hoag’s Dermatologic Oncology program offers you the highest expertise available in Orange County for skin cancer. Recruited from Memorial-Sloan Kettering Cancer Center, our Mohs surgeon, Steven Q. Wang, MD has more than 20 years of experience and focuses only on diagnosing and treating skin cancer and melanoma.
At Hoag, you are not alone.
Mohs surgery at Hoag offers you an exceptional cure rate with less scarring than traditional skin cancer surgery. Performed by our dedicated dermatologic oncologist, Mohs surgery removes all skin cancer, sparing healthy surrounding tissue. Mohs surgery at Hoag provides:
An experienced team, dedicated solely to skin cancer,
a Mohs surgeon with 20+ years of experience,
a comfortable, spacious & caring environment,
and treatments that are performed on an outpatient basis with local anesthesia.
Call for an appointment.
Mohs surgery provides the highest cure rate and spares the maximal amount of normal surrounding skin.
Medical Director of Dermatologic Oncology and Mohs Surgery at Hoag Family Cancer Institute
What You Need To Know
What is Mohs Surgery?
Mohs surgery is a type of surgery to treat skin cancer. It uses a special technique to remove ALL of the skin cancer but saves healthy tissue in order to limit scarring. Mohs surgery is the most effective treatment for skin cancer. It is often used to treat skin cancer that:
- May be on areas of the body where keeping appearance and function are important
- Has come back after being removed
- Has aggressive behaviors
- Covers a large area
- Grows quickly
What Happens During Mohs Surgery?
During your surgery, a layer of tissue will be removed from your skin and checked for cancer cells using a microscope. If there are cancer cells, more layers will be removed and checked for cancer cells. This will continue until all the skin cancer has been removed and the margins are clear.
Will I Be Under General Anesthesia?
You will not get general anesthesia (medication to make you sleep) during your surgery. You will receive a local anesthetic (medication to make an area of your body numb).
What Are The Risks From Mohs Surgery?
Talk with your health care provider about risks associated with Mohs surgery. Possible risks may include:
- Pain or tenderness at the surgery site
- Infection
- Bleeding from the surgery site
- Scarring
- Slow or poor wound healing
- Numbness at the surgery site
- The wound splitting open where the incision (surgical cut) was made. This is only a risk if your wound is closed with sutures (stitches).
Before Mohs Surgery
You will receive important information about how to prepare for your surgery and have time to review it and ask questions. If you are having a plastic surgeon close your wound, you will get more information.
Your health care provider will review your medications and health history.
If you develop any illness (fever, cold, sore throat or flu) or are hospitalized before your surgery, call your health care provider’s office.
Depending on how many layers of tissue need to be removed, you may be at Hoag for several hours. We recommend that you eat breakfast and bring lunch or snacks with you. We can store your food, if needed.
If you have any questions, call your health care provider’s office.
How Long Does Mohs Surgery Take?
The length of your surgery depends on how many layers of tissue are removed. Be prepared to spend 2-3 hours at Hoag. Again, we recommend that you eat breakfast and bring lunch or snacks with you. We can store your food, if needed.
During Mohs Surgery
First, you will get an injection (shot) of local anesthesia to numb the surgery site. Once the area is numb, the cancerous tissue and a thin layer of surrounding tissue will be removed. A bandage will be placed on your wound.
After your wound is bandaged, you will stay in the procedure room. You can relax and eat light snacks or your lunch while you wait.
A lab will process and examine the removed tissue. If there are cancer cells at the border (edge) of the tissue, they will need to remove another layer of tissue.
These steps will be repeated until they find no more cancer cells at the borders of the tissue.
Closing Your Wound
After all the cancer is removed, you and your doctor will discuss the best way for your wound to close and heal. Examples include:
- Allowing the wound to heal by itself.
- Suturing the wound.
- Creating a skin graft or flap to close the wound. A skin graft or flap is tissue that’s taken from one part of your body and moved to the area that must be covered.
- Having a plastic surgeon close the wound. If you need to have a plastic surgeon close your wound, this must be planned ahead of time.
Before you leave Hoag, you will get instructions about how to care for your wound at home. You will also be told when you need to come back for your follow up appointment.
After Mohs Surgery
You will be able to go home right after your procedure.
- You may have pain after your surgery. If you have pain, try taking extra strength acetaminophen (such as Tylenol Extra Strength).
- If you are allergic to acetaminophen or cannot take it due to a medical condition, ask your health care provider what you can take instead.
- Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil) or naproxen (Aleve) unless your health care provider says it is OK. These medications can cause bleeding.
- You can also hold an ice pack over your wound to reduce pain and swelling. Hold the ice pack for 15 to 20 minutes every hour or follow the instructions your health care provider gives you.
- If you have sutures, do not lift anything heavier than 15 pounds. The sutures will be removed during a follow-up appointment.
- Do not exercise or travel on a plane for two weeks after your surgery.
What is Mohs Surgery?
Mohs surgery is a type of surgery to treat skin cancer. It uses a special technique to remove ALL of the skin cancer but saves healthy tissue in order to limit scarring. Mohs surgery is the most effective treatment for skin cancer. It is often used to treat skin cancer that:
- May be on areas of the body where keeping appearance and function are important
- Has come back after being removed
- Has aggressive behaviors
- Covers a large area
- Grows quickly
What Happens During Mohs Surgery?
During your surgery, a layer of tissue will be removed from your skin and checked for cancer cells using a microscope. If there are cancer cells, more layers will be removed and checked for cancer cells. This will continue until all the skin cancer has been removed and the margins are clear.
Will I Be Under General Anesthesia?
You will not get general anesthesia (medication to make you sleep) during your surgery. You will receive a local anesthetic (medication to make an area of your body numb).
What Are The Risks From Mohs Surgery?
Talk with your health care provider about risks associated with Mohs surgery. Possible risks may include:
- Pain or tenderness at the surgery site
- Infection
- Bleeding from the surgery site
- Scarring
- Slow or poor wound healing
- Numbness at the surgery site
- The wound splitting open where the incision (surgical cut) was made. This is only a risk if your wound is closed with sutures (stitches).
Before Mohs Surgery
You will receive important information about how to prepare for your surgery and have time to review it and ask questions. If you are having a plastic surgeon close your wound, you will get more information.
Your health care provider will review your medications and health history.
If you develop any illness (fever, cold, sore throat or flu) or are hospitalized before your surgery, call your health care provider’s office.
Depending on how many layers of tissue need to be removed, you may be at Hoag for several hours. We recommend that you eat breakfast and bring lunch or snacks with you. We can store your food, if needed.
If you have any questions, call your health care provider’s office.
How Long Does Mohs Surgery Take?
The length of your surgery depends on how many layers of tissue are removed. Be prepared to spend 2-3 hours at Hoag. Again, we recommend that you eat breakfast and bring lunch or snacks with you. We can store your food, if needed.
During Mohs Surgery
First, you will get an injection (shot) of local anesthesia to numb the surgery site. Once the area is numb, the cancerous tissue and a thin layer of surrounding tissue will be removed. A bandage will be placed on your wound.
After your wound is bandaged, you will stay in the procedure room. You can relax and eat light snacks or your lunch while you wait.
A lab will process and examine the removed tissue. If there are cancer cells at the border (edge) of the tissue, they will need to remove another layer of tissue.
These steps will be repeated until they find no more cancer cells at the borders of the tissue.
Closing Your Wound
After all the cancer is removed, you and your doctor will discuss the best way for your wound to close and heal. Examples include:
- Allowing the wound to heal by itself.
- Suturing the wound.
- Creating a skin graft or flap to close the wound. A skin graft or flap is tissue that’s taken from one part of your body and moved to the area that must be covered.
- Having a plastic surgeon close the wound. If you need to have a plastic surgeon close your wound, this must be planned ahead of time.
Before you leave Hoag, you will get instructions about how to care for your wound at home. You will also be told when you need to come back for your follow up appointment.
After Mohs Surgery
You will be able to go home right after your procedure.
- You may have pain after your surgery. If you have pain, try taking extra strength acetaminophen (such as Tylenol Extra Strength).
- If you are allergic to acetaminophen or cannot take it due to a medical condition, ask your health care provider what you can take instead.
- Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil) or naproxen (Aleve) unless your health care provider says it is OK. These medications can cause bleeding.
- You can also hold an ice pack over your wound to reduce pain and swelling. Hold the ice pack for 15 to 20 minutes every hour or follow the instructions your health care provider gives you.
- If you have sutures, do not lift anything heavier than 15 pounds. The sutures will be removed during a follow-up appointment.
- Do not exercise or travel on a plane for two weeks after your surgery.
About Hoag's Melanoma & Skin Cancer Program
Led by recently recruited national experts in dermatologic oncology and surgical oncology—Steven Q. Wang, M.D and Thomas Wang, M.D., Ph.D., F.A.C.S., respectively—Hoag’s Melanoma & Skin Cancer Program is leveraging state-of-the-art technology to partner with community dermatologists and provide streamlined care for skin cancer patients. When disease is detected, Hoag’s multidisciplinary cancer team will collaborate to determine the best therapeutic modality for each patient, whether it be Mohs surgery, non-Mohs surgery or other innovative treatment modalities offered at Hoag, including immunotherapy and targeted therapy or access to clinical trials.