If you've just been told you need Mohs surgery, it's normal to have questions. What actually happens in that room? Will it hurt? How long will it take? And maybe most importantly — how do you know you're in good hands?
At Treasure Valley Dermatology, we get these questions every week from patients across Boise and the greater Treasure Valley. Here's an honest, detailed walkthrough of what a Mohs surgeon does, step by step, so you know exactly what to expect.
**Step One: Numbing and Removing the Visible Tumor**
Your Mohs surgeon starts by numbing the area with a local anesthetic — you'll be awake and comfortable throughout the entire procedure. Once numb, the surgeon removes a thin layer of tissue containing the visible portion of the cancer, along with a small margin of surrounding tissue.
**Step Two: Mapping the Tissue**
This is where Mohs surgery separates itself from other skin cancer treatments. Instead of sending the tissue to an outside lab and waiting days for results, your surgeon creates a precise map of the removed tissue, color-coding and labeling each section so its exact location on your body is recorded.
**Step Three: Processing and Examining the Tissue On-Site**
The tissue is frozen, sliced, stained, and mounted onto slides — a process that typically takes about an hour. Your Mohs surgeon then personally examines 100% of the surgical margin under the microscope, looking for any remaining cancer cells. This is the step that makes Mohs the gold-standard treatment for many skin cancers: the same doctor who performed your surgery is also the one reading your slides.
**Step Four: Repeating (If Needed)**
If cancer cells are still present in a specific area of the map, your surgeon returns only to that precise location and removes another thin layer — sparing as much healthy tissue as possible. This cycle repeats until the margins are completely clear.
**Step Five: Repairing the Site**
Once your surgeon confirms clear margins, they'll discuss the best way to close the wound — whether that's a simple stitch, a more involved reconstructive repair, or occasionally allowing the area to heal on its own. Because our surgeons perform both the removal and repair, you benefit from a plan that considers healing, function, and cosmetic outcome from the very first cut.
**Why the Surgeon Behind the Microscope Matters**
The accuracy of Mohs surgery depends entirely on the skill and experience of the person reading the slides. That's why fellowship training matters so much when you're searching for a Mohs surgeon near me — it means the surgeon completed a full year of additional, specialized training beyond dermatology residency, focused exclusively on this technique.
Treasure Valley Dermatology is home to Dr. Kelsey Ferrell, a board-certified dermatologist and fellowship-trained Mohs surgeon, alongside Dr. Dustin Portela, a board-certified dermatologist and dermatologic surgeon and Idaho native. Having two fellowship-trained Mohs surgeons under one roof is rare — and it means patients throughout the Treasure Valley have access to a level of surgical dermatology expertise not found at many practices.
**How to Find the Best Mohs Surgeon for Your Situation**
If you're trying to figure out how do I find the best Mohs surgeon, start with these questions:
- Is the surgeon fellowship-trained specifically in Mohs micrographic surgery?
- Do they perform both the tumor removal and the tissue reading themselves?
- Can they also handle the reconstructive repair, or will you be referred elsewhere?
- Do former patients describe feeling heard and cared for, not rushed?
Our patients consistently tell us they feel like they're "their only patient," even on our busiest days — and that kind of attentiveness matters just as much during a skin cancer procedure as clinical skill does.
**What to Expect on the Day of Your Procedure**
Plan for a longer appointment than a typical dermatology visit — Mohs surgery can take anywhere from one to several hours depending on how many rounds of tissue removal are needed. Bring a book, wear comfortable clothing, and expect to leave the same day with your wound already repaired in most cases.
If you haven't yet had a suspicious spot evaluated, it's worth reading our guide on Boise's sun and skin: when should you schedule a screening? to understand what warning signs to watch for. Learn more about our approach to Mohs Micrographic Surgery, and explore how we treat related conditions like basal cell carcinoma, squamous cell carcinoma, and melanoma.
**Searching for "Mohs Surgery Near Me"? Start Here.**
With two convenient locations serving the Treasure Valley, Treasure Valley Dermatology makes it easier to get expert Mohs surgery without long waits or long drives. If you've found a spot that concerns you or a biopsy has already come back positive, our team is ready to walk you through every step — with the same warmth and clinical excellence our patients have come to expect.
Ready to schedule? Contact Treasure Valley Dermatology today to meet with one of our fellowship-trained Mohs surgeons.
