MOHS surgery is usually performed in stages, depending on the size of the growth and the remaining cells after the initial surgery.
Dr. Sedgh will start by marking the margins of the skin growth as a guide for the procedure. Local anesthesia will then be administered to the area to be treated.
With a small scalpel, the doctor will carefully remove the visible portion of the skin cancer along with a thin layer of surrounding tissue before placing a temporary bandage on the incision. The removed tissues will then be sent to the laboratory for processing and examination.
In most cases, the first treatment does not always remove all of the cancerous cells, which is why Dr. Sedgh will need have the removed tissue samples examined by an onsite lab technician. The doctor will also create a map to keep track of the exact areas where tissue was removed so that if any remaining cancer is found upon examination of the undersurface and edges of the specimen, he will be able to pinpoint the exact locations of the residual cancer, allowing him maximum precision for the second treatment.
This process will be repeated as many times as possible to locate and remove all traces of cancerous cells from the affected area. Removal is done moderately and progressively to ensure the preservation of healthy tissue.
Once the microscopic examination reveals that all tissue samples are clear of cancerous cells, the surgical area is ready for repair, which involves a procedure known as cancer reconstruction.
The entire surgery can take a few hours up to an entire day in rare cases, but this would depend on the size and severity of the skin cancer.