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Mohs Surgery

Mohs Surgery

Mohs micrographic surgery is widely considered the gold standard for treating certain skin cancers, offering the highest cure rate of any skin cancer treatment while preserving as much healthy tissue as possible. At Genesis Dermatology in Jupiter, FL, Mohs surgery is performed by Dr. Gamret, a board-certified dermatologist and fellowship-trained Mohs micrographic surgeon, whose goal in every case is the same: completely remove the cancer and achieve the best possible cosmetic and functional outcome.
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What Is Mohs Surgery?

Mohs surgery removes skin cancer one thin layer at a time. After each layer is removed, it’s examined under a microscope on the spot, mapped, and checked for any remaining cancer cells at the edges and base. If cancer is still present, another layer is removed from precisely that location, and the process repeats until the entire margin is clear. Most tumors are fully removed within one to three stages, all in the same visit.

That real-time, layer-by-layer examination is what sets Mohs apart from other skin cancer treatments. Because the tissue is checked microscopically before you leave the office, rather than sent to an outside lab with results days later, Dr. Gamret can confirm complete removal the same day, and remove only the tissue that contains cancer, nothing more.

Why Mohs Surgery Is Safe and Effective

Mohs surgery has one of the highest cure rates of any skin cancer treatment, typically 97% to 99% for cancers being treated for the first time, and remains highly effective, though somewhat lower, for tumors that have recurred after previous treatment. That cure rate comes directly from the technique itself: because every margin is examined under the microscope before the wound is closed, Dr. Gamret can confirm the cancer is completely gone rather than relying on a visual estimate of how much tissue to remove.

It’s also one of the safer surgical options available for skin cancer. The procedure is done in stages under local anesthesia, so you’re awake and comfortable throughout rather than facing the risks associated with general anesthesia. Because only small amounts of tissue are removed at each stage, and the entire procedure is performed in the office on an outpatient basis, complication rates for infection and bleeding are low, and most patients’ complete treatment and reconstruction in a single day.

The tissue-sparing nature of Mohs surgery also matters cosmetically. Because only cancerous tissue is removed, rather than a wider margin taken as a precaution, healthy surrounding skin is preserved, which generally means smaller scars and better healing, especially important for cancers on the face, ears, nose, and neck, where Mohs is most often recommended.

Who Is a Good Candidate for Mohs Surgery?

Dr. Gamret will determine whether Mohs is the right approach for your specific case, but it’s most recommended for:
  • Basal cell carcinoma and squamous cell carcinoma, the two most common types of skin cancer
  • Skin cancers located on the face, ears, nose, scalp, hands, feet, or genitals, where preserving healthy tissue and minimizing scarring matters most
  • Skin cancer that has returned after previous treatment
  • Tumors that are large, have poorly defined borders, or were found to have aggressive features on biopsy
  • Skin cancer in patients who are immunosuppressed, where thorough margin control is especially important

Warning Signs to Watch For

Knowing what to look for on your own skin is the first step toward catching skin cancer early enough that Mohs surgery, or any treatment, can be as straightforward as possible. Watch for:
  • A new or changing mole, especially one that's asymmetrical, has an irregular border, multiple colors, is larger than a pencil eraser, or is evolving in size, shape, or color
  • A pearly or waxy bump, sometimes with visible small blood vessels
  • A flat, scaly, reddish patch that doesn't resolve
  • A sore that bleeds, oozes, or crusts and doesn't heal within three to four weeks, or one that heals and then reopens
  • Any new growth or spot that looks different from everything else on your skin

What to Do If You Suspect a Cancerous Spot

How you handle a suspicious spot in the days and weeks before your appointment can make a real difference.

Do

  • Schedule an evaluation as soon as you notice a spot that concerns you, don't wait to see if it resolves on its own
  • Take a photo and note when you first notice it, since tracking changes over time is genuinely useful information for your provider
  • Point out any other spots that have changed recently, even minor ones
  • Keep the area clean and leave it alone as much as possible until it's been evaluated
  • Mention any personal or family history of skin cancer at your appointment

Don't

  • Don't pick, scratch, or try to remove any part of the spot yourself
  • Don't apply over-the-counter wart removers, acne treatments, or other products to a spot you suspect may be cancerous
  • Don't wait for the spot to become painful before getting it checked, many skin cancers don't hurt, especially early on
  • Don't assume a spot is harmless just because it's small or hasn't changed quickly, some skin cancers grow very slowly
  • Don't delay a follow-up biopsy or referral if your provider recommends one

Why Choose Genesis Dermatology & Dr. Gamret

Mohs surgery requires a specific, additional level of training beyond general dermatology or general surgery, the surgeon must be equally skilled at removing the cancer, reading the tissue under the microscope, and reconstructing the resulting wound. Dr. Gamret is a board-certified dermatologist and fellowship-trained Mohs micrographic surgeon, meaning every stage of your care, from the initial removal to the pathology reading to the final closure, is handled by the same physician rather than being divided across different providers.

Dr. Gamret’s approach is built around two goals that go hand in hand: complete removal of every detectable cancer cell, and the best achievable cosmetic and functional result once that’s done. That includes training in specialized reconstruction techniques like skin flaps and grafts for more complex closures, and close coordination with other surgical specialists on the rare occasion a unique closure calls for it. As a full medical and cosmetic dermatology practice, Genesis Dermatology also means your care doesn’t end with the surgery itself, the same team is available for your ongoing skin cancer surveillance and any cosmetic concerns about the healed site down the road.

What to Expect: Your Mohs Surgery Experience

Here’s how a Mohs surgery day typically unfolds at Genesis Dermatology:

Before Your Surgery

  • No special preparation is required, but come well-rested and eat a normal breakfast
  • Continue your usual medications unless you're told otherwise; if you take aspirin, plan to stop it a week beforehand (Tylenol is fine for pain in the meantime)
  • Shower the night before or morning of surgery, since your dressing will need to stay dry for the first 24 hours afterward
  • Let us know in advance if you take antibiotics before dental procedures
  • Plan to spend most of the day with us, the average visit runs 2 to 4 hours depending on how many stages are needed

The Day of Surgery

Eat your usual breakfast and lunch and skip makeup if the treatment area is on your face. The area is cleaned, the visible tumor outlined, and the site numbed with a local injection, so you’re comfortable but awake throughout. Each stage takes about 15 minutes to remove, followed by 20 to 60 minutes of lab processing while you wait in our office. If any cancer is found extending beyond the first layer, we remove tissue only from that specific area and repeat the process until the margins are completely clear. Many patients bring a book, laptop, or snack to help pass the time between stages.

Reconstruction

Because Mohs surgery removes only what needs to come out, the resulting wound is generally smaller than with other surgical approaches. Once your margins are clear, Dr. Gamret determines the best closure method based on the wound’s size and location, most are closed the same day, in the same visit. For more involved reconstructions, Dr. Gamret’s training in specialized techniques like skin flaps and grafts allows for a closure designed around both healing and cosmetic outcome.

Recovery & Wound Care

Plan to take it easy for the first week after surgery. Stitches, when used, are typically removed 7 to 10 days later. Most patients manage post-surgical discomfort well with Tylenol, though you should call our office if you experience significant pain. Some tightness, itching, or altered sensation near the site is common and can take months to fully resolve, and complete healing, including fading of any redness, can take up to a year, with the most noticeable changes happening in the first few months.
  • Wash your hands with soap and water before touching the wound
  • Clean the area gently with soap and water, using a cotton ball or Q-tip to remove any crust
  • Pat the area completely dry with a clean cloth
  • Apply a thin layer of antibiotic ointment (such as bacitracin) with a clean Q-tip
  • Cover with a clean, dry dressing
  • Repeat this routine twice daily unless you're given different instructions

Understanding the Risks

Mohs surgery is performed on an outpatient basis and carries a low overall risk profile, but as with any surgical procedure, some risks exist. A scar is an expected outcome of any skin surgery, our goal, once the cancer is fully removed, is the best cosmetic result achievable for that wound. Wound healing can occasionally be less predictable than expected, factors like smoking, diabetes, and overall health can affect healing, and in rare cases a flap or graft doesn’t take as well as planned; even then, a good cosmetic outcome is usually still achievable, and scars can be revised later if needed.

Infection is uncommon in dermatologic surgery like Mohs, but any time skin is cut it’s a possibility worth watching for. Post-operative bleeding can occasionally occur, related to medications, blood pressure, or activity level, and should be reported to our office right away if it becomes excessive. Allergic reactions to sutures or dressings are rare but possible; let us know about any known allergies beforehand, though a new reaction to something you haven’t been exposed to before can still occur.

Home Healthcare Support

If you’re unable to care for your surgical site on your own or would like help with bandage changes, we’re happy to help arrange home healthcare services. Just let our staff know on the day of your surgery so we can make the appropriate arrangements.

Do's and Don'ts for Surgery Day & Recovery

Do

  • Notify us as soon as possible if you need to cancel or reschedule
  • Plan on spending most of the day with us on your surgery date
  • Take your usual medications on schedule unless we've instructed otherwise
  • Let our staff know if you take Coumadin or need antibiotics before dental work
  • Dress comfortably and bring a sweater, our office can run cool
  • Eat a normal breakfast and lunch unless told otherwise
  • Bring a book, laptop, or light snack to help pass time between stages
  • Expect some swelling and bruising after surgery
  • Arrange for a driver as you won't be able to drive home
  • Sleep with your head and shoulders elevated if your surgery was on the face, head, or neck
  • Take it easy for about a week, since bending or lifting can increase bleeding risk

Don't

  • Don't take herbal supplements that increase bleeding risk (vitamin E, garlic, ginkgo, ginger, feverfew, ginseng) for 1 to 2 weeks before surgery
  • Don't drink alcohol for 24 hours before or 48 hours after your procedure
  • Don't wear makeup if your surgery is on your face
  • Don't swim in pools, hot tubs, or the ocean while stitches are in place
  • Don't stoop, bend, or strain during bowel movements if your surgery was on the face, head, or neck

Ready to Take the Next Step?

If you have a spot you’re concerned about, or a biopsy has already confirmed skin cancer, don’t wait to have it evaluated. Schedule a consultation with Dr. Gamret at Genesis Dermatology in Jupiter, FL, to find out if Mohs surgery is the right path for you.
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Frequently Asked Questions

How long does Mohs surgery take?
Plan to spend 2 to 4 hours in our office on average, though the exact time depends on how many stages are needed to fully clear the cancer. Most tumors are removed within 1 to 3 stages.
The area is numbed with local anesthesia before each stage, so the procedure itself is not painful. Most patients manage any post-surgical discomfort well with Tylenol.
Mohs surgery has a cure rate of 97% to 99% for skin cancers being treated for the first time, among the highest of any skin cancer treatment, and remains highly effective, though somewhat lower, for cancers that have recurred after prior treatment.
Most wounds are closed the same day, on the same visit, once your margins are confirmed clear. Dr. Gamret is trained in specialized closure techniques, including skin flaps and grafts, for more involved reconstructions.
Stitches are typically removed 7 to 10 days after surgery, and most patients feel back to normal activity within a week or two, though complete healing of the wound and fading of the scar can take up to a year.
Because Mohs removes only the tissue that contains cancer, it preserves more healthy surrounding skin than other surgical approaches, which generally means a smaller scar and better cosmetic outcome, especially important on visible areas like the face, ears, and nose.