Mohs Micrographic Surgery

You Don't Have to Navigate a Skin Cancer Diagnosis Alone

Hearing the words "you have skin cancer" can stop you in your tracks, even when you know it's treatable. If a biopsy has confirmed skin cancer, or your dermatologist has flagged a spot that needs closer attention, it's normal to feel anxious about what comes next.

Idaho's high-altitude sun and outdoor lifestyle, from river days to ski season, mean many of our patients have spent decades of sun exposure on their skin before a diagnosis ever surfaces. The good news is that Mohs micrographic surgery is one of the most effective and precise treatments available for skin cancer, with a well-established track record and a straightforward process. You're in capable hands, and we're here to walk you through every step. Patients may be seen by any of our providers, and every member of our team is trained to evaluate and treat skin cancer.

What Is Mohs Surgery?

Mohs micrographic surgery is a specialized surgical technique for removing skin cancer, layer by layer, while preserving as much healthy tissue as possible. It's considered the gold standard for many basal cell and squamous cell carcinomas, particularly on the face, ears, scalp, hands, and other cosmetically or functionally sensitive areas.

• The surgeon removes a thin layer of tissue containing the visible cancer
• That tissue is examined under a microscope on-site, in real time
• If cancer cells remain, another thin layer is removed from precisely that location
• This continues, layer by layer, until the margins are completely clear
• Because the surgeon reads the slides personally, there's no waiting days for outside lab results

This method offers one of the highest cure rates of any skin cancer treatment, while minimizing removal of healthy surrounding tissue, an important consideration for scarring and cosmetic outcome.

What to Expect During Mohs Surgery

• Before surgery: The area is cleaned and numbed with local anesthesia, so most patients report only minimal discomfort during the procedure
• During surgery: Each layer of tissue is removed and processed in an on-site lab, which typically takes 45 to 60 minutes per layer
• Waiting between layers: Patients rest comfortably in the office while the tissue is examined; most procedures involve one to three layers total
• Repair: Once the margins are clear, your Mohs surgeon will discuss the best option for closing the wound, which may include stitches, a skin flap, or a graft, depending on size and location
• Total appointment time: Plan for several hours at the office, since the exact number of layers needed can't be predicted in advance
• Downtime: Many patients return to normal activities within a few days, though healing time varies based on the surgical site and repair method

What Results Look Like After Mohs Surgery

Mohs surgery is associated with some of the highest cure rates available for the skin cancers it treats, and most patients leave their appointment with the cancer fully removed the same day. Healing continues over the following weeks, and scarring typically becomes less noticeable over time as the site matures.

• Most patients are cancer-free at the site immediately following successful margin clearance
• Initial healing generally occurs over one to two weeks, though full scar maturation can take several months to a year
• Follow-up skin checks are recommended to monitor for new spots, since a prior skin cancer diagnosis increases the likelihood of future ones
• Your care team will explain any expected changes in appearance or sensation at the surgical site during your care plan

Who Is a Candidate for Mohs Surgery

• Adults diagnosed with basal cell carcinoma or squamous cell carcinoma, especially on the face, ears, nose, eyelids, lips, hands, feet, or genitals
• Patients with skin cancer in areas where preserving healthy tissue is especially important for appearance or function
• Individuals with a recurrent skin cancer that was previously treated with another method
• Patients with skin cancers that have poorly defined borders or aggressive features under the microscope
• Idahoans with a history of significant sun exposure from years of outdoor recreation, farming, or high-altitude living
• Anyone who wants the reassurance of same-day, complete margin confirmation rather than waiting on outside lab results

If you're unsure whether Mohs is right for your diagnosis, that's a conversation worth having directly with one of our providers. Not every skin cancer requires Mohs, and your treatment recommendation will be tailored to your specific case.

Frequently Asked Questions

Does Mohs surgery hurt?

The area is fully numbed with local anesthesia before any tissue is removed, so most patients describe only minimal discomfort, similar to a dental procedure. Some tenderness or mild soreness is common during the healing period afterward, and your care team will provide guidance on managing it.

How long does Mohs surgery take?

Plan for several hours at the office, since each layer of tissue takes time to process in the lab, typically 45 to 60 minutes. Most patients need one to three layers, but the exact number can't be known ahead of time, which is part of why the schedule allows flexibility.

Will I have a scar after Mohs surgery?

Some degree of scarring is expected any time skin tissue is removed and repaired. Your Mohs surgeon prioritizes precise, layer-by-layer removal specifically to minimize tissue loss and will discuss repair options designed to support the best possible cosmetic outcome for your specific site.

How do I know if my skin cancer needs Mohs surgery versus another treatment?

The decision depends on factors like the type of skin cancer, its location, size, and how it appears under the microscope. Your provider will review your biopsy results with you and recommend the treatment approach best suited to your diagnosis, whether that's Mohs surgery or another method.

Why Choose Treasure Valley Dermatology for Mohs Surgery

Treasure Valley Dermatology is home to Dr. Dustin Portela, Dr. Kelsey Ferrell, and Dr. Ben Buttars, board-certified dermatologists and experts in skin cancer surgery. Dr. Ferrell is also a fellowship-trained Mohs surgeon, giving Boise, Meridian, and the surrounding Treasure Valley access to this level of surgical specialization in one place.

• Board-certified dermatologists and experts in skin cancer surgery, all under one roof
• Dr. Portela is an Idaho native who understands the specific sun exposure risks tied to the state's altitude and outdoor lifestyle
• Dr. Ferrell, a Boise State University graduate, is known by patients for a genuine, attentive bedside manner
• Dr. Ben Buttars, DO, board-certified dermatologist and Idaho native
• Full-family dermatology care, from pediatric skin concerns to adult skin cancer treatment, all in one practice
• Two convenient locations serving Boise, Meridian, Eagle, Nampa, Caldwell, Star, Kuna, and surrounding communities
• 700+ five-star reviews reflect a practice culture where patients consistently say they feel like the doctor's only patient, even on a busy day
• Access to clinical trials for patients interested in advanced treatment options

Patients consistently describe the experience at TVD as "a breath of fresh air," with staff who are professional, knowledgeable, and genuinely invested in outcomes. When it comes to something as significant as skin cancer surgery, that combination of expertise and attentiveness matters.

Schedule Your Mohs Surgery Consultation Today

If you've been diagnosed with skin cancer or have a suspicious spot that needs an expert opinion, don't wait to get answers. Our providers are ready to walk you through your diagnosis, explain your treatment options clearly, and create a care plan built around your specific needs.

Schedule your consultation online at dermatologyboise.com/schedule-an-appointment or call our Boise or Meridian office directly. Treasure Valley Dermatology is here to give your skin the expert care it deserves, close to home.