Concierge dermatology · London
Mohs micrographic surgery London.
The highest cure rate skin cancer surgery, with complete margin control and minimal tissue removal. Same day excision and reconstruction under local anaesthetic in a London Mohs unit.
What Mohs surgery is
Same day excision with 100% margin control.
A specialist microsurgical technique for skin cancer with the highest published cure rates.
Mohs micrographic surgery is a specialist microsurgical technique for removing skin cancer. The tumour is excised in progressively wider layers under local anaesthetic, with immediate frozen section examination of 100% of the surgical margin in the on site Mohs laboratory. Further layers are taken only from areas where tumour is still present, until every margin is histologically clear.
Because the whole margin is looked at, rather than a small sample, Mohs achieves the highest published cure rate of any skin cancer treatment. Around 99% for primary BCC and 97% for primary SCC at five years. Just as importantly, only tumour bearing tissue is removed, so healthy skin on the nose, eyelids, ears and lips is preserved. The excision and the reconstruction are usually done on the same day.
Who it is for
When Mohs is the right choice.
High risk sites, high risk histology and recurrent or ill defined tumours.
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BCC on face, ears, hands, feet, genitals
High risk anatomical sites where tissue preservation and complete margin control matter most.
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High risk histological BCC
Morpheaform, infiltrating and micronodular subtypes with subclinical extension beyond visible edges.
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SCC on face or hands
Squamous cell carcinoma at high risk sites, or high risk histology, or recurrent SCC.
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Recurrent BCC or SCC
Tumours that have returned after previous excision, curettage or radiotherapy.
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Large or ill defined lesions
Tumours over 2 cm or with clinically indistinct borders where standard excision often misses margins.
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DFSP, EMPD and lentigo maligna
Dermatofibrosarcoma protuberans, extramammary Paget disease and lentigo maligna at select specialist centres.
Advantages over standard excision
Highest cure rate, minimum tissue lost.
Complete margin analysis rather than the bread loaf sampling used in standard excision.
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Cure rate BCC
99%
Five year cure rate for primary BCC treated by Mohs, higher than any other technique.
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Cure rate SCC
97%
Five year cure rate for primary cutaneous SCC treated by Mohs.
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Margin analysis
100%
The entire surgical margin is examined, unlike standard bread loaf sectioning which samples under 1%.
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Tissue removed
minimum
Only tumour bearing tissue is taken, sparing healthy skin on the nose, eyelids, ears and lips.
How the procedure works
Day case, 2 to 5 hours, local anaesthetic.
You wait between stages while the on site lab processes and reads the margin.
- 01
Local anaesthetic
The tumour and a small margin are numbed with lidocaine and adrenaline. General anaesthetic is not needed.
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Stage one excision
The visible tumour and a narrow rim are removed, orientated and mapped by the Mohs surgeon.
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On site frozen sections
The tissue is processed in the on site Mohs lab, cut horizontally and 100% of the margin is examined under the microscope. Each stage takes 45 to 90 minutes.
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Further stages if needed
Where tumour touches a margin, a further layer is taken only from that precise point. Repeated until margins are clear.
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Same day reconstruction
Once margins are clear, the defect is closed the same day by primary closure, local flap or skin graft.
Reconstruction
Closed the same day in most cases.
By the Mohs surgeon, or by a facial plastic or oculoplastic surgeon for complex defects.
Once margins are clear the defect is closed the same day. Small defects go to primary closure along a relaxed skin tension line. Larger defects, or defects on the nose, eyelids, ears and lips, are closed with a local flap or a full thickness skin graft, planned around the natural aesthetic units of the face.
For very complex reconstructions, for example a paramedian forehead flap for a nasal tip defect, a separate second consultation with a facial plastic or oculoplastic surgeon may be arranged. Scars heal over 6 to 12 months and are optimised with silicone gel or sheet, daily SPF 50 and avoidance of tension during the first six weeks.
Cost in London
£3,500 to £6,500 all inclusive.
Consultation, surgery, on site pathology and same day reconstruction. Larger or complex cases £6,500 to £12,000.
In short
Mohs in London: £3,500 to £6,500, day case under local.
The range reflects consultant fees, theatre and Mohs lab time, pathology, dressings and the same day reconstruction. Larger tumours, multiple stages or complex flaps and grafts run £6,500 to £12,000. We share firm quotes once the lesion has been reviewed.
Where it is performed
London Mohs units.
Dedicated Mohs suites with an on site frozen section laboratory and credentialed Mohs surgeons.
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Chelsea and Westminster Private Mohs Unit
Fulham Road. Dedicated Mohs suite with in house lab and reconstructive dermatology.
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HCA The Wellington Mohs
St John Wood. Senior Mohs surgeons with plastic surgery back up.
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Cadogan Clinic Mohs
Sloane Street. Boutique dermatology day case unit with Mohs on site.
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King Edward VII Mohs
Marylebone. Private hospital with Mohs and dermatology day case pathway.
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London Dermatology Centre Mohs
Wimpole Street. Consultant led Mohs with rapid pathology turnaround.
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Cromwell Hospital (Bupa)
South Kensington. Bupa flagship with Mohs and reconstructive lists.
NHS availability
Available at specialist NHS centres.
Free at the point of use with a wait, or same week privately.
Mohs micrographic surgery is available on the NHS at specialist skin cancer centres and is recommended by NICE for high risk BCC and SCC in the CG12 improving outcomes guidance. Typical NHS waits are 3 to 6 months from referral, depending on region and tumour urgency, longer in some trusts.
Private Mohs uses the same UK GMC registered consultants, often on their non NHS session, at the same clinical standard. It offers a consultation within a week and surgery within 2 to 3 weeks, which matters when a tumour is symptomatic, growing or on a cosmetically sensitive site.
Recovery
What to expect afterwards.
A quick, predictable recovery with careful scar management for the best cosmetic result.
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Dressing 24 to 48 hours
A pressure dressing stays in place for the first day or two to reduce bleeding and swelling.
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Wound care
Simple daily cleaning with saline or soap and water and a light petrolatum ointment.
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Sutures out at 5 to 10 days
Face at 5 to 7 days, trunk and limbs at 10 to 14 days, depending on the closure.
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Bruising and swelling
Most swelling settles by 7 to 10 days on the face. Arnica helps some patients.
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Scar management
Silicone gel or sheet and daily SPF 50 for 6 to 12 months to optimise the final scar.
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Follow up
Skin check every 3 to 6 months in the first year to screen for recurrence and new lesions.
Related
Related pathways.
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Photodynamic therapy
For AK and superficial BCC.
Learn more -
Superficial radiotherapy
Non surgical option for select BCC and SCC.
Learn more -
Sentinel node biopsy for melanoma
Staging for intermediate thickness melanoma.
Learn more -
Actinic keratosis treatment
Field treatment for sun damaged skin.
Learn more -
Seborrhoeic keratosis removal
Removal of benign pigmented lesions.
Learn more -
Mole mapping
Baseline imaging for high risk patients.
Learn more -
Breast reconstruction
For post oncology reconstruction pathways.
Learn more
Frequently asked
Mohs surgery, honestly answered.
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Why does Mohs take longer than a standard excision?
Because the margin is examined in full on the same day. Each stage of excision is followed by 45 to 90 minutes of frozen section processing in the on site lab. Most cases are cleared in one or two stages, so plan for 2 to 5 hours in total including the reconstruction.
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Is Mohs surgery covered by private medical insurance?
Bupa, AXA, Vitality, Aviva, WPA and Cigna all cover Mohs surgery for confirmed BCC or SCC at high risk sites with a specialist dermatology referral. We handle preauthorisation and coding on your behalf.
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Can Mohs be done under general anaesthetic?
The Mohs excision itself is almost always done under local anaesthetic because the patient waits between stages. If the reconstruction is complex, for example a forehead flap or a large graft, the closure alone can be scheduled under general anaesthetic on the same day or shortly after.
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What is the risk of recurrence after Mohs?
For primary BCC the five year recurrence rate after Mohs is around 1%. For primary SCC it is around 3%. Both figures are lower than standard excision, curettage or radiotherapy at high risk sites.
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How bad will the scar be?
Mohs takes the least tissue possible, so the defect is smaller than with a wide standard excision. Scars are placed in relaxed skin tension lines and mature over 6 to 12 months with silicone and sun protection. On the nose, ears and lips, a reconstructive flap or graft usually gives an excellent cosmetic result.
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What is the waiting time?
Private Mohs in London is usually booked within 2 to 3 weeks of consultation. NHS Mohs at a specialist centre currently runs at a 3 to 6 month wait depending on region and tumour urgency.
Speak to a London Mohs surgeon
Book Mohs surgery in London, with the right consultant.
We match you to a UK GMC registered Mohs surgeon who operates weekly at a dedicated London Mohs unit with an on site frozen section laboratory. Insurer preauthorisation handled.