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Mohs Surgery in Seville

Mohs micrographic surgery is a specialised technique for treating certain skin cancers.
It allows the tissue margins to be examined under the microscope during the procedure, layer by layer, until it is confirmed that the tumour has been completely removed.
Its aim is to achieve maximum oncological control while preserving as much healthy tissue as possible, especially in anatomical areas where it is important to preserve function and make reconstruction easier.
CLINICAL APPLICATION

Which tumours can be treated with Mohs surgery?

Mohs surgery is mainly used for certain skin cancers that, because of their clinical or histological characteristics, require particularly precise control of the margins. The indication must be assessed individually in each case.

Basal cell carcinoma

High-risk basal cell carcinoma is the main indication for Mohs surgery.

Squamous cell carcinoma

Mohs surgery is also indicated for certain high-risk squamous cell carcinomas.

Other tumours

Some types of melanoma (lentigo maligna), as well as dermatofibrosarcoma protuberans, are tumours that can also benefit from micrographic surgery.
INDIVIDUAL ASSESSMENT

When is Mohs surgery indicated?

Mohs surgery is not necessary for all skin cancers. Whether it is indicated is assessed individually according to the type of tumour, its location, size, clinical borders, histological characteristics, previous treatments and the patient's situation.

Critical anatomical areas

Tumours located in areas where it is particularly important to preserve healthy tissue, such as the eyelids, nose, lips or ears.

Recurrent tumours

Skin cancers that have come back after previous treatment or that have not been completely removed.

Poorly defined borders

Lesions whose clinical borders are difficult to identify or that show infiltrative growth.

High-risk tumours

Tumours with aggressive histological subtypes, perineural invasion or other factors associated with a higher risk of persistence or recurrence.

Type of reconstruction

Tumours that, because of their size or location, will require reconstruction using plasties or flaps.

Special situations

Certain tumours in immunosuppressed patients, in previously irradiated areas or in other contexts that increase their complexity and risk of recurrence.
PROCEDURE

What does Mohs surgery involve?

The Mohs surgery process in four stages: marking and local anaesthesia, excision and orientation, microscopic analysis of the margins, and selective re-excision.
01

Marking and local anaesthesia

The lesion is marked out and local anaesthetic is given.
02

Excision and orientation

The tumour is removed with a thin layer of tissue, which is oriented for examination.
03

Microscopic analysis

The margins are examined under the microscope and any remaining tumour is located on the map.
04

Selective re-excision

Only the affected area is re-excised and the analysis is repeated.
RECONSTRUCTIVE PLANNING

And after the excision?

Once the excision is complete and the margins have been confirmed to be free of tumour, the most suitable way to repair the surgical defect must be assessed.
Reconstruction is planned individually according to the location, the size of the defect and the characteristics of each patient.
Reconstruction Options
FREQUENTLY ASKED QUESTIONS

Practical information about Mohs surgery

No. It is reserved for tumours in which complete microscopic control of the margins and preservation of healthy tissue offer a significant advantage. The indication depends on the type of tumour, its location, size, borders, histological characteristics and previous treatments.

It is usually carried out under local anaesthesia. The patient remains awake during the procedure and can wait while each layer of tissue is processed and analysed.

The duration varies because it depends on the number of stages needed to achieve tumour-free margins. The microscopic analysis of each layer requires preparation time, so the procedure can last several hours.

The number of stages, or Mohs passes, cannot be known before the procedure. After each layer is analysed, additional tissue is removed only from the areas where tumour cells remain. The process ends when all the margins examined are clear.

Once the excision is complete, the most suitable option for reconstruction is chosen according to the size, depth and location of the surgical defect. This may be direct closure, a local flap, a graft or, in certain cases, allowing the wound to heal on its own.

Recovery depends on the location and extent of the surgery and the type of repair carried out. The patient receives individual instructions on wound care, physical activity, medication and follow-up.

Specialist consultation

Dermatologist · Dr. David Moreno
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