What is Mohs micrographic surgery and how is it different from a normal excision?

Mohs is a staged, microscopically-controlled excision. The tumour is removed in thin layers and the entire peripheral and deep margin is examined on-site by the surgeon acting as pathologist. Conventional excision only samples 1–2% of the margin, so subclinical spread can be missed - Mohs sees 100%.

Which skin cancers is Mohs used for?

High-risk basal cell carcinoma (large, aggressive subtype, recurrent, on the face - the H-zone - or in immunosuppressed patients), high-risk squamous cell carcinoma, dermatofibrosarcoma protuberans and some rarer tumours. It is not first-line for standard invasive melanoma or Merkel cell carcinoma.

How much does private Mohs surgery cost in the UK?

A single Mohs stage is roughly £2,500–£3,500. Most cases need two or three stages, so a typical private Mohs procedure is £3,500–£6,500, with reconstruction on top: £500–£1,200 for primary closure, £1,200–£2,500 for a local flap, £1,500–£3,500 for a skin graft.

How long does the appointment take?

Plan for 3–6 hours. Each Mohs stage is 20–30 minutes of surgery followed by 60–90 minutes waiting while the frozen sections are processed and read. If a further stage is needed you go back to the chair; if the margin is clear you go to reconstruction.

What kind of anaesthetic do you have?

Local anaesthetic only - you are awake and comfortable throughout, and no fasting is required. Sedation or a general anaesthetic is very rarely needed and only for specific reconstruction plans.

How is the wound closed at the end?

Once the margin is clear the defect is repaired the same day - a primary closure, a local flap (bilobed, rhombic, rotation, advancement), or a full-thickness skin graft. On some sites (medial canthus, concave ear, scalp) second-intention healing gives an excellent cosmetic result. Occasionally reconstruction is delayed.

What is the recurrence rate compared with standard surgery?

Five-year recurrence for BCC is 1–2% with Mohs versus 5–10% with standard excision. For high-risk SCC it is 3–5% with Mohs versus 8–15%. On the face and in cosmetically or functionally critical sites the tissue-conservation advantage is just as important.

Do I need surveillance afterwards?

Yes. Having one skin cancer significantly raises the chance of another, so long-term dermatology follow-up - typically annually and always self-checking - is part of the plan whichever technique was used.

Mohs micrographic surgery, by a BSDS-certified Mohs surgeon.

The gold-standard technique for high-risk non-melanoma skin cancer on the face - staged excision with on-site pathology in a single appointment, so the whole margin is examined and healthy tissue is preserved.

See indicative pricing

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private Mohs micrographic surgery costs in the UK.

Indicative ranges across our partner Mohs centres.

In short

£3,500–£6,500, plus reconstruction - done in a single appointment.

Procedure	Indicative range	Typical duration	Recovery
Consultation with Mohs surgeon	£250–£450	30 min	Same visit
Mohs surgery - single stage	£2,500–£3,500	2–3 hours	Same visit
Mohs surgery - 2–3 stages (typical)	£3,500–£6,500	3–6 hours	Same visit
Reconstruction - primary closure	£500–£1,200	30–45 min	Same visit
Reconstruction - local flap	£1,200–£2,500	45–90 min	Same visit or delayed
Reconstruction - skin graft (FTSG)	£1,500–£3,500	60–90 min	Same visit or delayed

Prices vary by centre, by how many Mohs stages the tumour needs (typically one to three), and by the reconstruction chosen. NHS Mohs is commissioned for patients who meet BSMS UK consensus criteria.

The problem

The right technique, the right surgeon, the right reconstruction.

High-risk skin cancer on the face is quietly one of the most under-triaged private procedures - offered as a standard excision when it should be Mohs, or as Mohs when a standard excision would do. We fix that before you commit.

Not sure Mohs is needed?

Not every skin cancer needs Mohs. A standard wide local excision is often the right call - we say so plainly.
Worried about the scar?

Mohs preserves the most healthy tissue possible. Reconstruction is planned by the same surgeon for the best cosmetic result.
Want it done properly?

A BSDS-certified Mohs surgeon in a centre with an on-site fresh-frozen pathology lab - not a general dermatologist with a batch send-out.

When it helps

When Mohs micrographic surgery is the right step.

The indications aligned with BSMS UK consensus criteria and NICE, plus the one situation where Mohs is not the right first-line technique.

High-risk BCC on the face

Basal cell carcinoma on the eye, nose, ear, lip or temple (the H-zone) - where tissue conservation and clear margins both matter most.
Aggressive-subtype BCC

Morphoeic, infiltrative, micronodular or basosquamous BCC - the subtypes with subclinical extension that conventional excision under-treats.
Recurrent skin cancer

A BCC or SCC that has come back after previous surgery, cryotherapy, curettage or radiotherapy - Mohs handles the distorted anatomy.
Incompletely excised skin cancer

A previous excision came back with positive margins on histology - Mohs is the definitive way to clear what is left.
High-risk SCC

Squamous cell carcinoma over 2 cm, poorly differentiated, deep (>6 mm), perineural, on the ear or lip, or in an immunosuppressed patient.
DFSP and rare tumours

Dermatofibrosarcoma protuberans has infiltrative margins that Mohs is uniquely good at clearing. Also MAC and, in some centres, lentigo maligna.
Immunosuppressed patients

Transplant recipients and long-term immunosuppression carry a much higher recurrence risk - Mohs lowers it substantially.
Red flag: melanoma or Merkel

Standard invasive melanoma and Merkel cell carcinoma are not first-line Mohs indications - you need melanoma-specific pathways instead.

Technique options

Mohs is not the only option - but it is the right one here.

What each technique on the table actually involves - and which fits which tumour and which patient.

Mohs micrographic surgery

The gold-standard staged, microscopically-controlled excision with on-site frozen sections and 100% margin examination.
Standard wide local excision

Conventional excision with fixed margin, sent to the lab afterwards - appropriate for low-risk tumours on low-risk sites.
Slow Mohs (paraffin-embedded)

A variant used mainly for lentigo maligna - sections processed with paraffin rather than frozen, with reconstruction delayed by days.
Curettage and cautery

For small, well-defined, low-risk superficial BCCs on the trunk or limbs - not appropriate for the face or aggressive subtypes.
Cryotherapy

Freezing with liquid nitrogen for very small, low-risk lesions - limited role in confirmed skin cancer on the face.
Radiotherapy

An alternative to Mohs in patients unfit for surgery, or as adjuvant after Mohs for perineural or high-risk SCC.
Reconstruction options

Primary closure, local flap (bilobed, rhombic, rotation, advancement), FTSG or STSG skin graft, or second-intention healing.
Consultation only

Safety and recovery

What to expect afterwards - honestly.

Mohs is a safe, single-appointment day-case procedure with excellent long-term outcomes. The things worth planning are the scar, the site-specific risks, and long-term skin surveillance.

A scar is unavoidable

Mohs conserves tissue but does not avoid a scar. Reconstruction is planned for the best cosmetic and functional result on the day.
Bleeding and infection are uncommon

Some oozing, bruising and swelling for one to two weeks is normal. Significant bleeding or infection is uncommon and the team is prepared.
Nerve injury is site-dependent

On the face, branches of the facial nerve and sensory nerves can be affected. The surgeon discusses site-specific risks before you consent.
Functional risks near key structures

Lower eyelid work risks ectropion; lip work can affect oral competence; nose work can narrow the nasal valve. Reconstruction plans account for this.
Reconstruction complications

Skin grafts and flaps can partly fail, needing dressings or a small revision. Second-intention healing takes weeks but often looks excellent.
The scar softens over months

Scars look pink and firm at first, then fade and soften over three to six months. Sun protection during that window matters.
Recurrence is rare but not zero

Five-year recurrence for BCC is 1–2% with Mohs versus 5–10% with standard excision; for SCC 3–5% versus 8–15%. Long-term surveillance still matters.
Incomplete removal is very rare

With adequate horizontal sectioning it is unusual for Mohs to leave residual tumour, but no technique is 100%. You are told the same day.
Red flags

Fever, spreading redness, heavy bleeding after surgery, or graft or flap changing colour dramatically - call the clinic or A&E the same day.

Reading your operation note

Your Mohs note in four parts. Read the last one first.

Whichever centre did the surgery, the note the Mohs surgeon sends you keeps to the same shape.

A UK Mohs surgeon reviewing frozen-section slides during a staged excision

A quiet reminder

Surgical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the note before your review, just ask.

01 Header

Tumour, site and indication

Which skin cancer (BCC or SCC subtype, DFSP, other), where it was, and which BSMS criteria made Mohs the right technique.
02 Technique

Stages, sections and margin status

How many Mohs stages were needed, which sites still had tumour at each stage, and when a clear margin was achieved.
03 Findings

Reconstruction and any incidental notes

Which reconstruction was done (primary, flap, graft, second intention), and any incidental findings on the removed tissue.
04 Impression

Wound care, review and surveillance plan

Read this first: dressing plan, review timing, sun protection, and how often you should be seen for long-term skin surveillance.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for Mohs micrographic surgery varies by insurer but is usually funded in full when a biopsy has confirmed a skin cancer meeting BSMS criteria. Reconstruction is normally covered under the same authorisation.

Frequently asked

Everything we get asked about Mohs surgery.

Quick answers on cost, appointment length, the scar, and why Mohs beats standard excision for high-risk tumours.

What is Mohs micrographic surgery and how is it different from a normal excision?

Mohs is a staged, microscopically-controlled excision. The tumour is removed in thin layers and the entire peripheral and deep margin is examined on-site by the surgeon acting as pathologist. Conventional excision only samples 1–2% of the margin, so subclinical spread can be missed - Mohs sees 100%.
Which skin cancers is Mohs used for?

High-risk basal cell carcinoma (large, aggressive subtype, recurrent, on the face - the H-zone - or in immunosuppressed patients), high-risk squamous cell carcinoma, dermatofibrosarcoma protuberans and some rarer tumours. It is not first-line for standard invasive melanoma or Merkel cell carcinoma.
How much does private Mohs surgery cost in the UK?

A single Mohs stage is roughly £2,500–£3,500. Most cases need two or three stages, so a typical private Mohs procedure is £3,500–£6,500, with reconstruction on top: £500–£1,200 for primary closure, £1,200–£2,500 for a local flap, £1,500–£3,500 for a skin graft.
How long does the appointment take?

Plan for 3–6 hours. Each Mohs stage is 20–30 minutes of surgery followed by 60–90 minutes waiting while the frozen sections are processed and read. If a further stage is needed you go back to the chair; if the margin is clear you go to reconstruction.
What kind of anaesthetic do you have?

Local anaesthetic only - you are awake and comfortable throughout, and no fasting is required. Sedation or a general anaesthetic is very rarely needed and only for specific reconstruction plans.
How is the wound closed at the end?

Once the margin is clear the defect is repaired the same day - a primary closure, a local flap (bilobed, rhombic, rotation, advancement), or a full-thickness skin graft. On some sites (medial canthus, concave ear, scalp) second-intention healing gives an excellent cosmetic result. Occasionally reconstruction is delayed.
What is the recurrence rate compared with standard surgery?

Five-year recurrence for BCC is 1–2% with Mohs versus 5–10% with standard excision. For high-risk SCC it is 3–5% with Mohs versus 8–15%. On the face and in cosmetically or functionally critical sites the tissue-conservation advantage is just as important.
Do I need surveillance afterwards?

Yes. Having one skin cancer significantly raises the chance of another, so long-term dermatology follow-up - typically annually and always self-checking - is part of the plan whichever technique was used.

Related treatments

Mohs micrographic surgery, by a BSDS-certified Mohs surgeon.

What private Mohs micrographic surgery costs in the UK.

The right technique, the right surgeon, the right reconstruction.

When Mohs micrographic surgery is the right step.

High-risk BCC on the face

Aggressive-subtype BCC

Recurrent skin cancer

Incompletely excised skin cancer

High-risk SCC

DFSP and rare tumours

Immunosuppressed patients

Red flag: melanoma or Merkel

Mohs is not the only option - but it is the right one here.