What to Expect on Mohs Surgery Day: A Step-by-Step Guide for Patients

If you’ve scheduled Mohs surgery to treat skin cancer, knowing how the day unfolds can take some of the uncertainty out of it. Mohs is a precise, staged procedure, which means the timeline depends on how many rounds of tissue removal your case requires. Most people spend a few hours at the office, much of it waiting while the lab work happens.

At Vivida Dermatology, our providers in Las Vegas and Henderson, Nevada, and St. George, Utah, perform Mohs surgery to remove skin cancer while preserving as much healthy tissue as possible. Here’s what you can expect from your visit.

Step 1: Getting ready before your appointment

We give you specific pre-surgery instructions, but a few general guidelines apply to most people, such as:

• Eat breakfast before your appointment
• Take your regular medications unless told otherwise
• Bring a book, tablet, or other way to pass the time during the periods between stages
• Wear comfortable clothing
• If the surgery site is on your upper body, choose a button shirt rather than a pullover

Finally, arrange for someone to drive you home if the procedure is on or near your eyes or if you expect to feel anxious afterward.

Step 2: Checking in and numbing the treatment area

When you arrive, our team checks you in and escorts you to a treatment room. We then examine the area, mark the visible boundaries of the skin cancer, and clean the site.

We inject a local anesthetic to numb the area completely. You stay awake throughout Mohs surgery, but you shouldn’t feel pain once the anesthetic takes effect. You might notice some pressure or a tugging sensation during the procedure.

Step 3: Removing the first layer of skin cancer

Once the area is numb, we remove the visible tumor along with a thin layer of surrounding tissue. This part of the procedure is quick, often taking just a few minutes.

After removing the tissue, we temporarily bandage the site, and you return to the waiting area while we process and examine it.

Step 4: Waiting while the lab examines your tissue

We take the removed tissue to an on-site lab, where we freeze it, slice it into thin sections, and examine it under a microscope. Then, we check the edges of the tissue for any remaining cancer cells.

This processing and examination typically takes 1-2 hours per stage. You wait during this period, so bringing something to pass the time helps.

Step 5: Removing additional layers if cancer remains

If we find cancer cells at the edges of the removed tissue, that tells us cancer remains in a specific area. You return to the treatment room, we numb the site again if needed, and remove another thin layer of tissue from only the cancerous area.

This targeted approach is what makes Mohs surgery so precise. Rather than removing a large margin of tissue upfront, your provider removes only what’s necessary, checking each layer until no cancer cells remain. Each additional stage involves another round of removal, processing, and examination.

Step 6: Closing and repairing the wound

Once the lab confirms that no cancer cells remain, your provider repairs the wound. How your provider closes the site depends on its size and location. Some options include:

• Smaller wounds that are sometimes left to close naturally over time
• Wounds closed with stitches
• Larger or more complex sites needing a skin flap or graft
• Sites referred to a reconstructive specialist for repair

Your provider discusses the closure approach with you before proceeding. 

Step 7: Wound care and recovery after Mohs surgery

Once the wound is closed, the team applies a bandage and gives you detailed wound care instructions. You’ll learn how to clean the area, change the dressing, and recognize signs of infection.

Most people experience some swelling, bruising, and mild discomfort in the days following surgery, which over-the-counter pain relievers usually manage. We set up a follow-up visit to monitor healing and remove any stitches. The duration of your recovery depends on the wound’s size and location.

Smaller sites heal within a couple of weeks, while larger repairs take longer. Because having one skin cancer increases the risk of developing another, regular skin checks after Mohs surgery are an important part of ongoing care.

Mohs surgery in Las Vegas, Henderson, and St. George

Understanding how the Mohs surgery day unfolds can make the experience feel more manageable. If you have questions about an upcoming procedure or want to learn whether Mohs is right for your skin cancer, contact one of our offices to schedule an appointment.