Mohs Micrographic Surgery

Mohs micrographic surgery is usually performed under local anaesthetic, meaning you’ll be awake, but the area will be completely numb throughout the procedure. We use a long-acting anaesthetic to ensure you remain comfortable and pain-free from the initial injection onwards.

Your consultant will begin by marking and removing a thin layer of the visible tumour, along with a small margin of surrounding skin. The sample is then taken directly to our on-site laboratory, located next to the operating theatre, where it’s examined under a microscope to check for any remaining cancer cells at the edge of the sample. While this analysis is taking place, a dressing will be applied to your wound, and you’ll return to a private, comfortable waiting area to relax.

If the surrounding tissue is clear of cancer, your surgeon will discuss the best way to close the wound — this is usually done on the same day and may involve stitches, a skin flap or a graft. In some cases, a specialist reconstructive surgeon may be involved to achieve the best possible cosmetic result.

If cancer cells are found at the edges, another thin layer of tissue is removed and examined. This process continues until the margins are completely clear. Around 70% of patients have their cancer fully removed in the first stage, but depending on the size or depth of the tumour, additional stages may be required. Because of this, it’s best to plan to be with us for at least half a day, and sometimes longer.

We recommend bringing something to keep you occupied, such as a book, tablet, or headphones, and a light snack or drink to help you stay comfortable and hydrated throughout the day. Once your procedure is complete and the wound is closed, your team will apply a fresh dressing and provide clear aftercare instructions before you go home.

One of the advantages of Mohs surgery is that your results are available within 30 minutes, meaning you’ll know before leaving whether the cancer has been completely removed.

Mohs surgery offers very high cure rates and preserves more healthy tissue compared to standard excision techniques. However, as with all surgery, there are some potential risks. 

Risks of Mohs micrographic surgery include:

• bleeding or bruising at the surgical site

• infection of the wound

• numbness or altered sensation in the area

• scarring, particularly if a flap or graft has been required

There’s a very small risk of incomplete removal of the tumour and therefore the need for further treatment.

Before your procedure, you’ll have a pre-operative assessment where your consultant will review your medical history, current medications, and any existing health conditions. Please inform us if you take blood-thinning medication such as aspirin or warfarin, or if you have a pacemaker, as this may affect your surgical plan. You’ll receive personalised advice on whether to adjust any medications before your surgery.

On the day, eat a normal breakfast and lunch unless advised otherwise, and ensure you stay well hydrated. Wear loose, comfortable clothing, and if your surgery is on your face or scalp, choose something that doesn’t need to be pulled over your head. Avoid make-up, perfume, and jewellery near the treatment area.

Because Mohs surgery can take several hours, we recommend arranging for someone to drive you home, especially if your wound is near a sensitive area.

After your Mohs surgery, a dressing will be applied to protect the wound, and you’ll be able to go home soon after. You’ll receive detailed wound care instructions, including how to look after your stitches or graft site and how often to change dressings. 

Mild swelling, bruising, or discomfort is common and can be eased with paracetamol — avoid aspirin as it can increase bleeding. Complications are uncommon but may include minor bleeding and infection. If bleeding occurs, apply firm pressure for 15 minutes with a clean cloth. If it continues, or your wound becomes red, painful, or swollen, get in touch.

Recovery time depends on the complexity of your procedure and the type of reconstruction performed. In most cases, wounds heal within 1 to 2 weeks, although larger or more complex repairs may take longer. Your surgeon will explain what to expect before you go home. 

We recommend taking at least a few days off work, or up to a week, to allow yourself time to rest and recover fully. Avoid exercise, swimming, heavy lifting, and gardening for at least 1 week to reduce the risk of bleeding or wound complications.

Your consultant will arrange a follow-up appointment to check your healing progress, remove any stitches if needed, and review your results. They’ll also discuss long-term scar care and sun protection to support the best possible cosmetic outcome.

Please contact the Skin Health centre or Surgery Centre for pricing. 

At Welbeck, our dermatologists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

To book Mohs micrographic surgery, you must be referred by either your GP or a dermatologist following a consultation with them. Self-referrals are not accepted for this treatment.

If you’d like to schedule a consultation with a Welbeck dermatologist, please get in touch to make an appointment. Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.