Mohs Skin Cancer Surgery


Mohs skin cancer surgery, also called microscopic surgery, is the most effective technique for treating common types of skin cancer including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Skin cancer treatment is most successful when started right away, so it is important to see a dermatologist at the first signs of skin cancer. Mohs surgery gives patients the highest cure rate with the lowest chance of recurrence. Because we take small margins around the cancer, it leaves the smallest possible defect size resulting in the smallest possible cosmetic plastic surgery reconstruction. Jupiter Dermatology offers Mohs skin cancer surgery to patients in Jupiter, FL for effective removal and reconstruction if necessary.



Mohs skin cancer surgery is used to treat skin cancer by removing all cancerous cells from the skin. The procedure happens in stages to remove a small layer of cancerous tissue at a time. The tissue is mapped accordingly to a clock so the precise location can be identified and correlated with the patient and what is seen under the microscope. The tissue is frozen and cut horizontally to evaluate the edges and the base in a 360-degree fashion to evaluate 100 % of the true margin. If any cancerous tissue is seen under the microscope, an additional layer that corresponds to the area on the patient’s skin is removed and re-submitted to the lab for a second stage of frozen section processing. Once Dr. Ricardo Mejia, who is board certified and a fellow in Mohs surgery, has removed all the cancer, then the defect will be closed via plastic surgery reconstruction techniques to leave the smallest possible scar and the best cosmetic outcome.

Mohs skin surgery works to preserve as much healthy tissue as possible. Because of this, it is termed a “tissue sparing technique” in order to give the smallest appearing scar as possible following reconstruction.


Mohs skin cancer surgery is most often used to treat basal cell carcinoma and squamous cell carcinoma as well as other types of skin cancer. Mohs skin cancer surgery might be used to treat early stages of melanoma as well, the deadliest form of skin cancer. Signs that you might require Mohs skin cancer surgery include lesions that show one of the following characteristics:

  • Lesions located in or around sensitive areas such as the face scalp, eyes, ears, mouth, hands, feet, and genitalia
  • Size, usually greater than 2cm
  • Growth or lesions that have poorly defined borders
  • A basal cell or squamous cell carcinoma that has recurred after a previous excision or treatment

While Mohs skin cancer surgery is often the preferred method of skin cancer removal, it isn’t recommended for everyone. Mohs skin cancer surgery is generally recommended to those with only one skin cancer or a few skin cancer lesions that are very close together.


Mohs surgery is most often used in cosmetically important areas such as the face, scalp, hands, feet, and genitals so that the most healthy tissue will be preserved, however, Mohs surgery can be used to treat skin cancer on other areas of the body as well. Mohs surgery can be done on any location if patients want the smallest possible scar. However, it is only covered by insurances in select circumstances. Mohs surgeons follow clinical guidelines to determine whether Mohs surgery is needed or not, such as the items described above and cosmetically sensitive areas that require tissue sparing techniques. Dr. Ricardo Mejia follows the guidelines published by the American Academy of Dermatology (AAD ) on the appropriate use criteria (AUC) on Mohs micrographic surgery. These guidelines were developed in collaboration with the following organizations:

  • American College of Mohs Surgery
  • American Society for Mohs Surgery
  • American Society for Dermatologic Surgery Association


To begin treatment, Ricardo Mejia, MD will inject local anesthesia around the biopsy site to numb the area. After the shot, you should not feel any more discomfort during your procedure. A thin layer of visible tissue is then removed, and Ricardo Mejia, MD will map the area to be tested and analyze the tissue to determine if any cancerous cells remain. Your wound will be temporarily bandaged while you wait. The lab analysis will show where more skin cancer is present and the area mapped on the patient’s skin. If any cells remain, Ricardo Mejia, MD will then remove another layer of tissue and continue the testing/mapping process until no cancerous cells are detected. Depending on the size of your wound, it may be left open to heal or closed with stitches. The entire process can be as simple as one hour or several hours if multiple stages are required to clear the cancer in a very precise fashion and to avoid loss of normal skin.


After Mohs skin cancer surgery, Dr. Mejia will determine how the wound should be treated. Some wounds heal well with stitches, while larger wounds may require a skin graft for reconstruction. Dr. Mejia will provide patients with everything they need to care for their wound after surgery. The treatment site should be kept dry for the first 24 hours and a dressing should be left on at all times. Heavy lifting and physical activity should be avoided for several days to avoid excess bleeding. Swelling is common for the first week after Mohs skin cancer surgery and can be controlled with an ice pack. With Mohs skin cancer surgery, scarring is very minimal, and the cure rate is extremely high.


After being diagnosed and treated for skin cancer, some extra precautions should be taken. While the cure rate from Mohs surgery is very high, you could still be at risk for future skin cancer in other areas or close to the current skin cancer.

  • Be aware of any new, changing, or irregular growths.
  • Be aware of a pimple that doesn’t heal.
  • Be aware of a red rash that persists that does not go away.
  • Avoid tanning beds and wear sunscreen regularly.
  • Most importantly, do not get sunburns.

Studies have shown that women that have used tanning beds under the age of 25 have a 100% chance of developing a basal cell carcinoma. Our practice at Jupiter Dermatology specializes in topical treatments to reduce the risk of future skin cancers from developing.


If you notice any suspicious lesions on the body, contact our dermatologist right away for skin cancer removal and testing. Not every dermatologist in Jupiter, FL offer Mohs skin cancer removal. Jupiter Dermatology offers Mohs skin cancer surgery and plastic surgery reconstruction to those in the Jupiter, FL area as well as Palm Beach Gardens, Tequesta, Hobe Sound, and Stuart.

Dr. Mejia’s Mohs and plastic surgery skills are highly regarded. He is sought out by other dermatology practices to provide the same excellent care to their patients.   He dedicates his time to assist dermatology practices in Boca Raton Florida with Derm Partners, Dr. Shari Topper, and Dr. Jodi Fiedler. He also dedicates time to help patients at the Center for Dermatology in Coral Springs with Dr. Peter Wallach.


Can a pimple turn into skin cancer?

We have seen pimple popper MD pop lots of pimples. Unfortunately, patients that have skin cancer usually say it started like a pimple and they ignore it for several months. That is why, if you have a pimple that doesn’t heal, you should have it properly evaluated by a board certified dermatologist. Call and schedule your consultation today with our Mohs Surgeon, Dr. Ricardo Mejia if you have a pimple that has not healed or has persisted for several weeks.

How will the scar look after Mohs surgery? Will I need plastic surgery?

Following the Mohs surgery, Dr. Ricardo Mejia will use a variety of plastic surgery reconstruction techniques to assure a great cosmetic outcome. Dr. Mejia has received specialized plastic surgery training during his residency in dermatology and dermatologic surgery. He was mentored and trained by several plastic surgeons in achieving the best cosmetic outcomes after Mohs surgery.

Are there alternatives to Mohs skin cancer surgery?

Although Mohs skin cancer surgery is the preferred method of skin cancer removal due to its high cure rate and ability to preserve the most healthy tissue, this method isn’t for every patient and there are several alternatives. A traditional surgical excision can also be performed, removing the skin cancer and surrounding tissue. Some patients might also be candidates for a shave excision where the abnormal area is scraped off the surface of the skin, depending on the type of cancer they have and its stage. Other methods include cryotherapy to freeze the skin cancer surgery or laser surgery to remove a surface lesion. Radiation or chemotherapy for skin cancer may be required only if the cancer has spread to other areas of the body.

Can skin cancer return after Mohs surgery?

Mohs surgery has a very high cure rate, meaning it is unlikely that the same area will still be cancerous after removal. However, Mohs surgery does not prevent the development of future lesions and skin cancer. If you have a history of skin cancer, you are more likely to develop skin cancer again in the future. This is why it’s so important to understand the signs of skin cancer and follow preventative tips including receiving regular skin examinations from a dermatologist like Dr. Mejia.

How much does Mohs surgery for skin cancer cost?

Because Mohs surgery is performed for medical purposes, it is covered by most insurances. The cost of your Mohs surgery procedure will depend on the type of cancer present, the stage it is in, and the size of the area.

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