Mohs Surgery

Due to the methodical manner in which tissue is removed and examined, Mohs surgery has been recognized as the skin cancer treatment with the highest reported cure rate for basal cell carcinoma, the most common type of skin cancer, and for squamous cell carcinoma. Mohs surgery is done in an office setting under local anesthesia. Puyallup Dermatology Clinic has a CLIA certified Lab on site to perform Mohs surgery.

Mohs History:

Mohs micrographic surgery is a specialized, highly effective technique for the removal of skin cancer. The procedure was developed in the 1970s by Dr. Frederic Mohs at the University of Wisconsin and is now practiced throughout the world. Mohs surgery differs from other skin cancer treatments in that it permits the immediate and complete microscopic examination of the removed cancerous tissue, so that all “roots” and extensions of the cancer can be eliminated. .

The Mohs Procedure:

Mohs surgery is performed by Dr. Newman here at Puyallup Dermatology. The area to be treated is cleansed, marked, and injected with a local anesthetic. Although the patient is awake during the entire procedure, discomfort is usually minimal and no greater than routine skin cancer surgeries. A mild sedative is available to patients upon request. Dr. Newman removes the visible cancer along with a thin layer of additional tissue. This procedure takes only a few minutes, and the patient waits while tissue is being processed and examined.

Processing and Examination:

The removed tissue specimen is cut into sections, stained, and marked on a detailed diagram. Tissue is then frozen and cut on a cryostat. A technician removes very thin slices from the entire edge and undersurface of the frozen tissue. These slices are placed on slides and stained for examination. Dr. Newman carefully examines the slides under a high power microscope. If the edges and undersurfaces are free from cancer, then the tumor has been successfully removed. If any cancerous cells or microscopic “roots” are detected, they are precisely identified and pinpointed, directing the removal of additional tissue. This process is repeated as many times as necessary to locate any remaining cancerous areas within the surgical site. After the skin cancer is removed the surgical defect is repaired.

Repair and Reconstruction:

After the skin cancer is removed, Dr. Newman repairs the resulting defect to restore the function and appearance of the surgical site. Dr. Newman has extensive training and experience in the repair and reconstruction of surgical defects on the face and other body sites. Often, with small cancers, the repair is accomplished by simply bring the wound edges together to create a linear closure. With more difficult or large cancers, plastic surgery techniques such as flaps and grafts may be employed. If you have questions regarding surgical repairs after Mohs surgery, please ask Dr. Newman.


Most insurance policies cover the costs of Mohs surgery and the reconstruction of the resultant surgical defect. Please contact your insurance carrier directly for the most current payment information relative to this surgery. The insurance billing department in our office can also assist you.

Your Dermatologist can determine if Mohs surgery is right for you.