What is Mohs Surgery?

The most advanced treatment for skin cancer

AboutMohs Micrographic Surgery

Mohs surgery is an advanced surgical technique that has the highest cure rate for skin cancer.

Want to learn even more? Visit our FAQs page.

An Overview

Mohs surgery is used primarily to treat the two most common types of skin cancer: basal cell carcinoma and squamous cell carcinoma. Dr. Frederic Mohs originally developed the technique in which one physician serves in three distinct roles as cancer surgeon, pathologist, and reconstructive surgeon. Mohs surgery differs from all other skin cancer treatment methods because it combines intraoperative microscopic examination of the cancer with detailed mapping of the entire three-dimensional surgical margin. This precision allows board-certified, fellowship-trained Anir Dhir, M.D. to remove only tissue involved with cancer, with a cure rate of over 99.5%.

What Happens During Mohs Surgery?

Dr. Dhir performs the surgery in our state-of-the-art office while you are awake. Local anesthesia, and sometimes a mild oral sedative, are used to keep you comfortable throughout the procedure. He removes the visible skin cancer along with a thin rim (“margin”) of surrounding skin. A bandage is placed, and you are allowed to relax, and even eat or drink, while our in-house laboratory prepares slides for examination. Dr. Dhir checks the edges of the specimen for cancer cells using a microscope. If additional cancer cells are seen, more tissue is removed from precisely the area involved with cancer. Once Dr. Dhir confirms that all cancer has been removed, he utilizes plastic surgical techniques to reconstruct the wound to minimize scarring and give you the most natural result. The wound may be closed with stitches, a flap, or a graft. In some cases, a wound may be allowed to heal on its own.

Cure Rates and Cosmetic Results Are Better

The purpose of any cancer treatment is to remove all traces of tumor. Cancer roots are often hidden below the surface of the skin and are easily missed with traditional treatments. Unfortunately, all non-Mohs techniques (e.g. scraping and burning, standard excision, and radiation) rely on the unassisted human eye to determine the extent of disease. As a result, these less accurate techniques are associated with cure rates of 90-94% or less, meaning they fail to cure the cancer in at least one out of every ten to twenty treatments. Non-Mohs approaches also lead to repeat surgeries in as many as 1 in 5 cases, because the physician is effectively guessing where the true cancer margins lie.

By contrast, the cure rate at Arizona Mohs Surgery with Mohs surgery is over 99.5%, so the risk of a treatment failure is reduced to less than one in 200 surgeries.

Because Mohs surgery is so precise, the amount of tissue removed is also minimized, resulting in smaller wound which requires smaller reconstruction and heals more quickly.

Mohs Surgery Is Cost-Effective and Efficient

We are committed to providing the highest quality and safest care at the lowest possible cost.

Our surgeries are performed entirely under local anesthesia in our outpatient office that was designed and built specifically for Mohs surgery using the best U.S.- and German-manufactured equipment and instruments. By focusing on office-based care without putting you to sleep, we eliminate the traditional costs of an ambulatory surgery center or hospital, and the potential risks of intravenous / general anesthesia and alternative therapies such as radiation. Our approach can reduce the cost of a single skin cancer surgery by several hundred or even a few thousand dollars. Dr. Dhir examines the tissue himself while you wait to make sure that the cancer has been completely removed before performing any needed reconstruction. Therefore, a single visit is generally sufficient, and there are no additional pathologist costs in the vast majority of cases. The entire visit (consultation, preparation, anesthesia, excision, tissue examination, and reconstruction) typically lasts 2 to 4 hours. Much of that time is spent waiting comfortably while we prepare and examine the tissue.

Mohs Is the Treatment of Choice for Both Primary and Recurrent Cancers

Mohs surgery is the treatment of choice for cancers located in cosmetically or functionally critical areas such as the face, neck, scalp, and hands. It is also the best approach for non-facial tumors measuring at least 2 cm in diameter, as well as aggressive or rapidly growing cancers and those with ill-defined edges on clinical examination. Because Mohs surgery is more accurate than any other approach, many cancers are sent to Dr. Dhir after failing other attempts at therapy. These “recurrent” cancers may be more serious and often significantly larger than they appear on the surface. The same is true for large or neglected tumors, and those arising in patients with a history of cigarette smoking. Please be advised that these tumors typically require more time and effort to cure, and may occasionally need more than one surgery and/or occasional referral to other specialists if deeper structures (e.g. muscle, bone, cartilage, nerves, tear ducts, the inside of the nose) are involved with cancer. Also, tumors at higher risk for “metastasis” (spread to internal organs) may require additional treatment, such as lymph node dissection, radiation therapy, chemotherapy, or immunotherapy, even after microscopically clear margins are obtained.

Dr. Dhir is one of the most experienced skin cancer surgeons in the country, having performed over 40,000 Mohs procedures since 1999. His friendly, compassionate team has worked together for many years, and they are committed to your health, comfort, and a positive experience.

Information You Can Trust

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See What Our Clients Are Saying

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My contact with your office with questions about the procedure was greeted with full explanations and a courteous spirit.  Warmth without professionalism leaves one uncertain; professionalism without warmth leaves one uncomfortable. Gladly, you and your staff combined both warmth and professionalism.

—S
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I don't know anyone who says, "I'm so happy I'm going to the doctor today". However, your staff did an excellent job of making me very comfortable. I know I'm not the only patient and your call was appreciated. It brought back memories of my childhood and our family doctor. You are a good doctor and I would recommend your facility to anyone. I spent a lot of time with your staff and they support you with kindness and compassion.  You made it an experience I can remember with fondness.

—AS
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I feel like the luckiest person on earth that I was sent to you.  You have the lightest touch while working, but the determination to get things right like a 5 Star General.  You are rare.

—JM
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I would like to thank you and your staff for the wonderful care I received in having my nose growth removed.  I appreciate how quickly you were able to see me and your expert care.

—MS
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Special thanks for performing surgery on my face recently .  I appreciate all the discipline, experience, and education you have invested over the years in order to become an excellent surgeon.  You are really serving the public well and saving lives as you go.  Congratulations to you and your fine firm.

—JM
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I just wanted to thank you for taking such good care of my mother through two separate procedures. You have a kind and calming manner that is very rare today in the medical field, especially with the elderly, the ones that need it the most. And it is very much appreciated. Thank you again. May God bless you and your family.

—DB
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Thank you so much for sharing your talents with me the last couple of years. You have been so kind and you can't imagine what a difference you have made in my life. You are a wonderful doctor!

—PB
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Dr. Dhir, Erika, & Lindsay, The surgery site on my forehead healed quickly, with no aches, pain, or scarring.  You did great.  :-)  Your "fun" attitude makes my visits a breeze.  Thanks Much!!

—TK
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I would like to thank Dr. Dhir who is as good as it gets in giving patient care. In this day and time when health care is criticized for various reasons, it is very refreshing to have an organization such as yours doing it the right way. Since my experience with your people, I feel very good about health care and will let others know that you are not only dedicated to your craft but are also dedicated to your patients. Thank you again for making this a very pleasant experience.

—WY
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