Mohs Micrographic Surgery

Mohs micrographic surgery removes skin cancer one thin layer at a time. Each layer is frozen, cut and examined under the microscope while you wait, and the surgeon goes back only to the exact spot where tumour remains. The cycle repeats until the edges are clear.

It gives the highest cure rates for basal cell and squamous cell carcinomas, around 97 to 99 percent for new tumours, while sparing as much healthy skin as possible, which matters on the nose, eyelids, lips and ears. It is slow and labour intensive, so it is kept for higher-risk tumours, and it has a limited role in melanoma.

What Mohs Micrographic Surgery involves

A biopsy must already have confirmed the diagnosis. On the day, the visible tumour is marked and the area is numbed with local anaesthetic. The surgeon removes the obvious tumour with a narrow margin, cutting the specimen in a saucer shape, and makes orientation nicks and a map. The tissue is colour-coded with inks, frozen, sliced horizontally so that the whole outer edge and base appear on the slides, and stained. The surgeon, acting also as pathologist, reads the slides. Any remaining cancer is plotted on the map and only that segment is re-excised. Each stage takes 1 to 2 hours, mostly waiting with a dressing on. Once clear, the wound is repaired the same day with direct closure, a local flap or a skin graft, or occasionally left to heal naturally.

Who is a good candidate for Mohs Micrographic Surgery?

It is reserved for tumours where either the cure rate or tissue preservation is critical.

• Basal or squamous cell carcinoma on the central face, eyelids, nose, lips, ears, scalp, fingers or genitals
• Tumours that have recurred after previous treatment
• Aggressive microscopic patterns such as infiltrative or morphoeic BCC, or perineural invasion
• Large tumours or those with poorly defined borders
• Skin cancers in people with a suppressed immune system

It is usually not the right choice if:

• Small, well-defined, low-risk tumours on the trunk or limbs, where standard excision or other treatments work well
• Most invasive melanomas, which are treated with wide excision and margins measured in centimetres
• People unable to lie still for repeated stages under local anaesthetic
• Tumours that have spread deeply into bone or the orbit, which need a multidisciplinary head and neck approach

Technique options

• Fresh frozen Mohs: The classic same-day technique described here.
• Slow Mohs (staged excision with paraffin sections): Layers are processed overnight over several days. Used for lentigo maligna and some rare tumours where frozen sections are unreliable.
• Reconstruction by the Mohs surgeon: Most wounds are closed the same day with stitches, a flap or a graft.
• Reconstruction with oculoplastic or plastic surgery: Planned for large defects of the eyelid, nose or lip, sometimes the following day.

What happens during your treatment

Allow the whole day. Most tumours clear in 1 to 3 stages. You are awake; the numbing injections sting and then you should feel only touch. Between stages you wait in a lounge with a dressing. Bring something to read and eat normally. Repair adds 30 to 90 minutes.

Preparing for your trip

Plan for 7 to 10 days, to include stitch removal in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

Recovery and results

A pressure dressing stays on for 24 to 48 hours. Bruising and swelling, especially around the eyes, peak at day 2 to 3. Stitches on the face come out at 5 to 7 days. Avoid strenuous exercise, bending and alcohol for a week to reduce bleeding. Scars are red and firm at first and fade over 6 to 12 months; massage and sun protection help. You need skin checks every 6 to 12 months afterwards, because having had one skin cancer raises the chance of another.

• Back to everyday activity: About 1 week
• When results show: Cancer clearance confirmed the same day
• How long they last: Cure in about 97 to 99 percent of new tumours

Safety, risks and revision policy

It is safe surgery under local anaesthetic. Most concerns are about the scar and the repair.

• Bleeding or haematoma, more likely on blood thinners
• Wound infection
• Partial failure of a flap or graft
• A scar that is more noticeable than hoped, or distortion of the eyelid, lip or nostril
• Numbness around the scar, or rarely weakness if a small motor nerve is involved
• A larger wound than expected, because the tumour extended beyond what was visible
• Recurrence, in about 1 to 3 percent of new tumours

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Mohs Micrographic Surgery in Türkiye

Clinic-Y does not publish a single price for Mohs Micrographic Surgery, because the honest figure depends on your case. What moves it:

• Number of stages needed, which cannot be known in advance
• Complexity of the reconstruction
• Tumour site and size
• Whether a second specialist carries out the repair

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions