The surgical route is common and efficient.

The surgeon performing the Mohs procedure assesses the area where the excision will be done and often highlights it using a pen for reference. Local anaesthesia is then administered to completely numb the area to be treated.

The surgeon removes the top layer of the cancerous cells using a scalpel. Some types of cancer can be deeply rooted with extensions that aren’t visible superficially. This is determined via a lab examination.

The surgeon cuts the tissue into several sections and then codes them using dyes to plot a map of the site that was treated. The extracted tissues are then frozen in the laboratory. Next, the tissues are cut into very thin horizontal slices, just like a layered cake. The thin slices are later placed onto microscope slides, stained, and covered. This step is the most time consuming.

Under the microscope, the surgeon analyzes the base and edges of the stained tissue. In case he finds any remaining cancerous cells, he marks their location on the map.

If a second round of tissue removal is required, the surgeon injects more anaesthesia, if required, to remove the next layer of the skin. These steps can be repeated multiple times until no cancer cells are left.

When the site becomes free of all cancer cells, the surgical wound is either left open or closed using stitches, depending on the location and size of the wound. In some cases, reconstruction with a skin flap is required. At times, the surgeon seeks help from physicians like hand surgeons, plastic surgeons, or oculoplastic surgeons for wound repair.