Understanding Mohs surgery: A comprehensive guide

Written by: Miss Charlotte Defty
Edited by: Conor Dunworth

Mohs surgery is an invaluable technique in treating certain skin cancers and ensuring effective removal while preserving healthy tissue. In her latest online article, renowned consultant reconstructive and plastic surgeon Miss Charlotte Defty delves into the most commonly asked questions surrounding Mohs surgery.


What is Mohs surgery?

Mohs surgery is a specialised technique primarily used for treating skin cancers, especially those on sensitive or critical areas like the face. It involves a meticulous process of removing cancerous tissue layer by layer and examining it under a microscope in real-time. This step-by-step approach ensures the complete removal of cancer cells while minimising unnecessary sacrifice of surrounding healthy tissue.


How is Mohs surgery performed?

The procedure commences with the surgical removal of the visible tumour. This is then processed by the surgeon and slides are created to allow examination of 100% of the specimen margins.  These are examined for any cancer cells. If cancer cells are identified on any of the margins, the site involved is accurately located and a further layer is removed from this area.  This process is repeated until the cancer cells have been removed and ensures minimal impact on healthy tissue. The surgical site is then carefully reconstructed, focusing on function and aesthetics.  Since the tumour is known to have been completely removed without the need to wait for further results, the optimal reconstruction can be performed.


What skin conditions are suitable for Mohs surgery?

Mohs surgery is highly effective for treating various types of skin cancer, notably basal cell carcinoma and squamous cell carcinoma, especially when they appear in sensitive or cosmetically important areas. It’s also beneficial for recurrent or aggressive tumours and cases where preserving healthy tissue is critical.


What are the benefits of Mohs surgery?

The key advantage of Mohs surgery lies in its high cure rates while sparing healthy tissue. Its meticulous nature ensures the maximum removal of cancerous cells, reducing the likelihood of cancer recurrence and minimising scarring. Moreover, its real-time examination of tissue ensures precise tumour removal, enhancing its effectiveness.


Is Mohs surgery painful?

Local anaesthesia is administered during Mohs surgery, ensuring that the patient experiences minimal discomfort during the procedure. Post-operative pain is generally mild and managed well with prescribed medication, allowing for a comfortable recovery.


What is the recovery process like?

Recovery from Mohs surgery is typically straightforward. Patients may experience mild discomfort, swelling, or bruising around the surgical site, which subsides gradually. Following post-operative instructions and keeping the surgical site clean are crucial for optimal healing. Depending on the complexity of the procedure, sutures may be removed within a week or two.


Are there risks associated with Mohs surgery?

While Mohs surgery is considered safe, as with any surgical procedure, there are potential risks such as infection, bleeding, or unfavourable scarring relating to the site and extent of disease. However, these complications are rare and can be minimised by following post-operative care instructions diligently. 

In conclusion, Mohs surgery stands as a gold standard in the treatment of certain skin cancers, offering high cure rates with minimal impact on healthy tissue. If you have been diagnosed with skin cancer, consult with a qualified plastic or dermatologic surgeon to determine if Mohs surgery is the appropriate treatment for you.

Remember, early detection and timely intervention are crucial in effectively managing skin cancer. If you have any concerns or questions, don’t hesitate to discuss them with your doctor.



If you would like to book a consultation with Miss Charlotte Defty, you can do so today via her Top Doctors profile.

By Miss Charlotte Defty
Plastic surgery

Miss Charlotte Defty is a distinguished consultant plastic and reconstructive surgeon based in Liverpool, with over 15 years of experience. Miss Defty’s areas of expertise encompass Mohs surgery, scar treatment, skin cancer, laser surgery, botox, and blepharoplasty.

With a commitment to providing comprehensive care, she currently serves as a consultant plastic and reconstructive surgeon at ASET Hospital, where her sub-specialities include laser hair removal, tattoo removal, vascular lesion removal, thread vein treatment, ablation of unwanted lesions, facial resurfacing, and laser scar treatments.

Miss Defty earned her medical degree, MBChB, from Liverpool University. She went on to receive various prestigious qualifications, such as an MRCS and FRCS(Plast) from the Royal College of Surgeons. She also holds a BTEC Certificate in Laser.

Upon completing her plastic surgery training in Merseyside, she further honed her skills through fellowships in laser surgery in Swansea, and orthoplastic reconstructive surgery at the Queen Elizabeth Hospital, Birmingham. Notably, her Mohs training at St Helens and Knowsley NHS Trust solidified her expertise in skin cancer treatment.Beyond her clinical work, Miss Defty has actively contributed to the medical field through publications and conferences, showcasing her dedication to research. As a member of BAPRAS (British Association of Plastic, Reconstructive and Aesthetic Surgeons), Miss Defty upholds the highest standards in her practice.

Miss Charlotte Defty is highly committed to excellence, as evidenced by her positions as Laser Lead and Assistant Mohs Lead at St Helens and Knowsley NHS Trust. Her holistic approach to plastic and reconstructive surgery positions her as a trusted professional dedicated to the well-being of her patients.

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