The Mohs surgeon will first examine the area to be treated and confirm the site with you. You will then be prepped for the surgery. The site will be cleaned and then injected with a local anesthetic. This injection only numbs the area that will be treated. You will be awake during the surgery.
The Mohs surgeon will then cut the visible skin cancer out and then a thin layer of surrounding skin. While the tissue that has been removed is being processed in the lab, you will be bandaged up and will wait typically around 1-2 hours.
Once the tissue has been processed, the Mohs surgeon will examine the tissue under a microscope to see if all the skin cancer cells have been removed. If the Mohs surgeon sees more cancer cells, he/she will need to remove another thin layer of skin. You will then repeat the process.
Once cancer cells are no longer seen, your surgeon will decide how to treat your wound. Some wounds heal nicely without stitches. Others need stitches. To minimize the scar and help the area heal, some patients require a skin graft or other type of surgery. The Mohs surgeon will communicate with you what type of closure you will have.
For more detailed information please refer to the America Academy of Dermatology Association (AAD).