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Mohs Surgery

A skin cancer diagnosis is serious, and you need a doctor who is skilled and experienced with Mohs surgery to treat it. Mohs, an advanced tumor removal procedure, is the latest technique available to remove skin cancer tumors with a high cure rate and without disfiguring scars.

Mohs surgery allows Dr. Timani to detect the exact line and size of the tumor and leads to complete tumor removal. In the past, the surgery has left cancerous cell behind because typically less than 1% of the tissue removed was analyzed. Leaving cells behind can lower the rates of survival and lead to a recurrence of the cancer. The older surgical method was more guesswork. Because of the way the tissue is examined as Mohs surgery is taking place, there is little chance of missing cancer cells.

Mohs surgery is a real advancement because it provides a higher cure rate and allows the surgeon to preserve skin which is not cancerous. Mohs, state of the art surgery, is different because the tissue is examined while the patient is in the office on the day of surgery. The pathology procedure allows 100% of the tissue border to be examined. Frozen tissue sections are submitted and checked before the patient is released. Traditional surgical pathology could take up to 24 hours for tissue analysis.

Examining tissue during the surgery has two major benefits. It allows Dr. Timani, to see if any cancer cells have been left behind, and to pinpoint the specific location of any remaining portions of the cancerous tumor. The goal is to eliminate the guesswork in estimating the size and location of the growth.

About the procedure

During Mohs micrographic surgery, Dr. Timani will first surgically remove the tumor in a circular shape. Once the tissue has been removed, the whole border of the excised tissue will be divided into small sections, which are stained and analyzed using a microscope. The margins of the tumor are the most important concern in this procedure. When examining the margins, she analyzes the growth of the tumor and maps it before surgically removing any further skin. The mapping allows Dr. Timani to pinpoint the length, breadth, and depth of the melanoma. Additional excised sections are analyzed under the microscope. The process continues until microscopic analysis no longer shows presence of cancer cells.

Because the tissue is analyzed during the Mohs procedure, reconstructive surgery can begin right after tumor removal is complete. The traditional surgeon would have to wait to receive pathology reports before beginning reconstruction. Mohs surgery can last anywhere from a few hours to the entire day. This varies from patient to patient, depending on how extensive the tumor is. An asymmetrical tumor or a tumor with longer tentacles requires more stages or excisions to clear the tumor.

After the initial segment of the skin is excised, the patient returns to the waiting room, while Dr. Timani and her team segments, stains, and analyzes the tissue border. If analysis shows presence of cancer cells in the border, you will be asked to return to the procedure room, where additional tissue will be removed for analysis. This process will continue until analysis shows that the tumor has been removed completely.


The Mohs surgery team will provide you complete aftercare instructions based on the extent of your surgery and the area of the body treated. Johns Creek Dermatology and Family Medicine serves patients throughout north Atlanta. Patients come from Milton, Roswell, Johns Creek, and Alpharetta for treatment and Mohs surgery.